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HomeMy WebLinkAboutUpdated permit application All APPLICABLE INFO MUSTMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ^ Date: �o • a-1• -,;L- '\ Permit Number: O 0 �y 13 9V'o JICM RECEIVED 0 • OCT 21 2020 Building Permit Application Planning and Development Services 'Lucre Co�r� Permi 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: 'PROPOSED IMPROVEMENT LOCATIO n Address: Property Tax ID#: 3�1'c��,-O c��.— (�( IV^�T�(�C�U'y Lot No. Site Plan Name: Block No. Project Name: S i -3 -( i 5 L=ah=11 n rnCxxS New Electrical Meter _Second Electrical Meter (Affidavit required) e( 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: $ (2p •on Utilities: —Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR:_ Name l Name: Address: '3�� �'� Sy lay (t Company: City: /)�� ,�Q( g State: `L Address: Zip Code: '3 L}Q�� Fax: City: State: Phone No. 7-7 11 -' E- Zip Code: Fax: T Mail: i I O Phone No Fill in fee simple Title Holder on next page (if different E-Mail _ from the Owner listed above) State or County License If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. If value of HAVC is$7,500 or more,a RECORDED Notice of Commencement is required.