HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOIW6. r:PPLICATION TO BE ACCEPTED
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Building Permit Application
Planning and Develop ent Services
Building and Code egulation Division Commercial Residential
2300 Virginia Av nue,Fort Pierce FL 34982
Phone: (772),462-5553 Fax:(772)462-1578
PERMIT"APPLICATION FOR: )-
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Address:_"��2 2�( IM a�S�• �'ef� �� � � r a �.-�
Site Plan Name: m oySkn yK i Block No.
Project Name: A)♦'-e v,
1 Dee. 1, e- st/L
New Electrical Meter Second Electrical Meter (Affidavit required)
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VA: 0117110
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Additional work to be performed under this permit-check all that apply:
,Mechanical _Gas Tank —Gas Piping _Shutters ,Windows/Doors--Po
Electric _Plumbing p, ,Sprinklers _Generator I_Ro
Total Sq. Ft of Constr i n: Sq. Ft. of First Fioor:
Cost of Constructio L'kns'lz Utilities: _Sewer _Septic Building Height:
_ •Er,' yy:4ri 3'�?'`
Name LLe Le ne ( dui Name: S� eyl !'on�ef�,
Address: 2'Zt( gr4(n TO/ Company:S k ewf �fa���•t ���
City: (ESL State:P Address:3s?y f3• M e t#%n 1 A j
Zip Code: I Il I q'(.O Fax: City:_N, e-, k- Stater
Phone No. Zip Code: 3TR"t O Fax:
E-Mail: Phone No 33 L - W-9-
Fill in fee simple Title bolder on next page (if different E-Mail �v .re_Fron� erg Ut{1 Ia 61 • C&"
from the Owner listed above) State or County License CC-C ( 3 2 (n�i ? O
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.