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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
LLC1IL
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:
PROPOSED IMPROVEMENT LOCATION:
Address: 4807 Barcelona Ave. Fort Pierce, FL 34946
Property Tax ID #: 141-703-0164-000-2 Lot No.
Site Plan Name: Block No. H
Project Name: Tillman - 11117012
DETAILED DESCRIPTIONOF WORK:
Replace 5 windows size for size
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: $ 9528.00 Utilities: —Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Irene Tillman
Name: cis 30'L ,'A C"WtA2X_
Address: 4807 Barcelona Ave.
Company: The Home Depot
City: Fort Pierce State: FL
Zip Code: 34946 Fax:
Phone No. E-
Address: 2455 Paces Ferry Rd. C11
City: Atlanta State: GA
Zip Code: 33039 Fax:
Phone No 407-768-3357
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail robertosanchezthd@expeditepermit.com
State or County License CGC1255717
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.