HomeMy WebLinkAboutBuilding permit app (2)All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: \\"A\A—a\ Permit Number:
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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: �.C Cai
PROPOSED IMPROVEMENT LOCATION:
Address: � D � �I'!� � L��\"� �- �4 L�-2 t
Property Tax ID #: Lot No.
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
New Electrical Meter Second Electrical Meter_
CONSTRUCTION INFORMATION:
(Affidavit required)
Additional work to be performed under this permit- check all that apply:
_Mechanical
_ Electric
_ Gas Tank
Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $
—Gas Piping
Sprinklers
_ Shutters
_ Generator
Block No.
_Windows/Doors —Pond
Sq. Ft. of First Floor:
Roof Pitch
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Address: L�� t-� AsC
Company:
City: a�' �L V\ CK =-t. State: �EL
Zip Code: Fax: Fax:
Phone No °711-�-1�"L-C FN(Y5 E-
Address:5LE\ 5;\-a�-1C\
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Zip Code: Fax:
Phone No `�°��T�6�>�U�
state:�
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Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail 6� ' C »�L ' \f' CA7C li�L Cc
State or County License CCJOICACDU 0�
If value of construction is 2500 or more, a RECORDED Notice of t;ommencement is requirea.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.