HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
P, E c- ri c u' t-;� 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: bJ-1evx�uj( Olo L"
Property Tax ID #: �30� ! 8� t "CV7 U Lot No.�
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
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New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit- check all that apply:
_Mechanical Gas Tank —Gas Piping _ Shutters _ Windows/Doors _ Pond
Electric V/ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ I t )-c -'-p Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name boc'—.P Qqs� �-� (
Name: '
Y1 SPL4Qw0v
Address: -I �I� WeM YN
Company:
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City: JT u�Ue wlQ SState: R
Zip Code: 311M Fax:
Phone No. E-
Address: 11
OU-) DeOh
City: fbe
Zip Code:
Phone No —7-7
GUae State: F-1-
6 Fax:
=117 --(20�
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail tA&e' VJk4N\C'00 - c0VVJ
State or County License Cj c' )- 099
11 Vd1Utl U1 LUIMLrucuUn is vuu or more, a Ktwnutu Notice of commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.