HomeMy WebLinkAboutBUILDING PERMIT APP-UPDATED VERBIAGEAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: 1 'I Permit Number:
Ur ctllliz
i Building Permit Application
Planning and Development Services
f Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APliCATION FOR: R�-
PROPOSED IMPROVEMENT LOCATION:
Address: �'!��3 ► i I �3f�.� e� ! F l
Property Tax ID #: 'i -70 — Q M O- — wo Lot No. ,g (�
Site Plan Name: _ Block No.
Project Name:t/�Cr t I� l,i -
r
DETAILED DESCRIPTION OF WORK:
shinQV, an re A a for, (s .
New Electrical Meter —_ Second Electrical Meter (Affidavit required)
i CONSTRUCTION INFORMATION:
Additional work to be performed under this permit- check all that apply:
Mechanical ^ Gas Tank — Gas Piping _ Shutters -Windows/Doors Pond
_ Electric _ Plumbing _ Sprinklers Generator Roof Pitch
Total Sq. Ft of Construction: i Sq. Ft. of First Floor:
Cost of Construction: $ z Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: ---- CONTRACTOR: _
Name.. f _ -- Name: b r
I Address: Company:_ nth-pD C_�
City: ►0t State: Address: C5� 1
Zip Code: �` Fax: _-- ;City: _PLLr1�ac State:
Phone No.mmp p -�_` E Zip Code: �i Fax:p_- ---------
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Mail: (VQr("r Af.5e-- 3''T �� 013-co, '' Phone No 72 - 42 ` 3(1� i
Fill in fee simple Title Holder on next page (if different E-Mail-jOb n (' COD�� ) nlb �?
from the Owner listed above) State or County License LCC I LA,,30
If value of construction is 2500 or more, a RECORDED Notice of Commencement is requirea.
if value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.