HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
L, Ur CAU L�,"�
axa ...
1? c E c E!, C." � �= 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: q -tDJt) Pe( nR
Property Tax ID #: .33A7' 7N C'5 —OW —fro
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
of ra c.P-vv\,Pi"-� or so
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
(Affidavit required)
Lot No._
Block No.
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:
Cost of Construction: $ 1 Wo
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name ev, Ti
Name: )1cX�
Address: 5 &3 ►2R \.kJ
Company: L( Chi ✓VICG
City: CQQY,,r\,QiI State: X
Zip Code: 10S (Z Fax:
Phone No.9-73 c56 2 :J 27(b E-
Address:6A)Y kkk) ��
City: 1 oz-` -1 S+ --� e' State: FL
Zip Code: 2J -1 q eG Fax:
Phone No 19,9- -T 77-0010
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail pie, iV i VIG V 00 C.O (Nt
State or County License C F-(-- 1 c'.2, 9'O) l
u vdlue or construction is z:ouu or more, a K1:LUKutu Notice of commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.