HomeMy WebLinkAboutapplicationAll APPLICABLE INFO (MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I�' I42` a-'1 Permit Number:
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Building Permit Application
Planning and Development Services
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 APPLICATION FOR: Iry\C6�aA i ca,
PROPOSED IMPROVEMENT LOCATION: AA
Address: 4\CS
Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
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New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
Mechanical Gas Tank —Gas Gas Piping T Shutters _ Windows/Doors _ Pond
Electric _ Plumbing —Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ C1C3 .
Sq. Ft. of First Floor: _
Utilities: —Sewer _Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name..W -
Name: cc
Company: 'DU JL re&AydpiIuS Vnec
Address:3ct I i0e'- -S
City: S�241 4-1. State: _
Zip Code: 39g5 I Fax:
Phone No. S - M1 ' 4 012-1 E-
Address: - e NV
City: A- State: fi-
Zip Code: Fax: 3310
Phone No 3 ' ?L3q4
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail J 0JA2Ytbei!'O ks p, AVA • CUB
State or County License GMC J -)-y 9CWT _
If value of construction is 2500 or more, a RECORDED Notice of commencement is requires.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.