HomeMy WebLinkAboutBUILDING PERMIT APPLICATION PAGE 1 i
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AIIIAPPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ,,\\
Date: Permit Number:
Building Permit Application
Planning and Development Services.
Building and Code Regulation Division Commercial X Residential
2300 Virginia Avenue,Fort Pierce FL 34982
Phone- (772)462-1553 Fax: (772)462-1578 CBDG Funding j
PERMITAPPLICATION'FOR: EI.t�0�—%- L,C LGD LJ
PROPOSED IMPROVEMENT LOCATION
Address: kD Sa S S 06,t0-0 n e-, sjz►,S,::Q '-, T::�
Property Tax ID#: 615 11 040'�:' -066 r a Lot No.
Site Plan Name: Block No.
Project Name: '_P;,2-Az-a QZ"S- vAA-Po ` *At,;-�
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DETAILED DESCRIPTION'OF.WORK:
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New Electrical Meter Second Electrical Meter (Affidavit required)
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CONSTRUCTION INFORMATION
Additional work to be performed under this permit-check all that apply:
_Mechanical _Gas,Tank _Gas Piping _Shutters _Windows/Doors _Pond
I K Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: 5-1 Sq. Ft. of First Floor:
Cost of Construction:$ C}r 5O0r &0 Utilities: —Sewer _Septic Building Height:
01NNER/LESSEE , y q % CONTRACTOR, , ;, -
Nameyjti" eRodF' ►ter 3AD
Address: Compa`ny:..,ei A'y.
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City:_��� s3� 6 State: G -Address: �4�1�t "5 '`'ee°rtr�i s4&$77 40`z-
Zip Code: '?i 07S7 Fax: City: State: ,
Phone No. ?73- a01 -t a0'-�- E- Zip Code: I&{4 1; Fax:
Mail:_L,rz¢1J v -g g"eRd,a('C6A-co,1, Phone No -77a - Sao- "2377
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Fill in fee simple Title Holder on next page(if different E-Mail YtiA¢-fl AD CGO51 6/ 6�IA-iL CtJ'VI
from the Owner listed above) State or County License ei5 /aoo !/40
Ifbalue 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.