HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: f a 1- 6�_ 1 Permit Number:
lio LUr L4U
e_ Building Permit Application
Planning and Development Services '��//
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
A_-_-_. ( 7)-? 2 � < C),q,.- t;c' -W _,IMF
Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
Cp• a o ch +o ri I LJ 5 eef e St Cool pe Wk=t— (0 w �
i Lt (1, K e
New Electrical Meter Second Electrical Meter
I CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
_Mechanical _ Gas Tank — Gas Piping _ Shutters
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 4(5700•__�
(Affidavit required)
Windows/Doors Pond
Generator Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Weight:
OWNER/LESSEE:
CONTRACTOR:
Name Aay�vryj Ffrkehe,
Name: Cr
Address: I 0 7 2-S • ocea.A or -W3I
Company: [) orb f i 5 5
City: JJ. ¢ State:_
Zip Code: '3c(ck5 t Fax:
Phone No. 09 3392- E-
Address: I �LGI L S C S i4 PI
City: c,,-+ ✓�-l�G�e State: ` t
Zip Code: 34aS% Fax: 335 -3310
Phone No 3iig 34 o
E-Mail��,p I ef,+,eC e A44 , Cowl
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
State or County License QV.C- 1 XL( CigOM
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.