HomeMy WebLinkAboutWH permit application pg 1 - Inserra - 1204 -PCAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ;' a3 aj Permit Number:
L.. Ll! Cfui�- _,...
p `" Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial _
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
Residential
PERMIT APPLICATION FOR: Wa)cr Realt 'aV e Cttk
PROPOSED IMPROVEMENT LOCATION:
Address:OCCarlk-,-w- -Un;+ i?D4 Bc,61Fr,.a01167 9;Nct-4,CW b-o
Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name:
I DETAILED DESCRIPTION OF WORK: I
c lrlP_afei +ask C.k"a�, DL-0- - 38 aL lowboy
1oroy ess;vr)cL i G I ec r C' J v
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 Piping _ Shutters _ Windows/Doors _ Pond
_ Electric �/ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ /5 SO • 0a Utilities: -Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Jo S r
Name:-4e� 1114
Addressq[ego S:()C&ryl (Drive- ' hi Ia0
Company: BWew,&r Pk tg'nat IteTrW9V��D0.c�
City: �er\,W-Ptc VA State: l'L
Zip Code: 9 C�H 67 Fax:
Phone No.309-176 - 6g (o-7 E-
Address: 600 FC115�
City: 125 L State:
Zip Code: 5il /1ct� q OS Fax:
Phone No71c2- 30I- L 33�
Mail: C-ox in—rc j eilSOfrl,,. • VVi,
_io
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail b1 ieLLbkrpt. lic.& rw, it, coyig
State or County License CRC 1430c L4
If value of construction is 2500 or more, a RECORDED Notice of Commencement is regwrea.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required. 11