HomeMy WebLinkAboutST LUCIE PERMIT APPLICATION-All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: UL,2 3 ! CQ S
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: SS 'L L -?D49S 2
Property Tax ID #: 3 2- -r�iv - iJQa (� Lot No.
Site Plan Name: Vt �-+Z . 3 �SZ. Block No.
Project Name: 7�
DETAILED DESCRIPTION OF WORK:
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 _ Plumbing _ Sprinklers _ Generator — Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor: _
Cost of Construction: $ Utilities: —Sewer —Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
Name:
Company:
Address: LhXl) (71 I Li tA; ;� C� '
City: State:-
Address: 0
Zip Code: , 5(,-'.�1 Fax:
City: rt, S;-e.
State: (✓�
Phone No. q 5 Ct - y G - K7 E-
Zip Code: ' 5 i Fax: 964 31 ?5b�
Mail:
Phone No `j -Sg$- 6
C1
Fill in fee simple Title Holder on next page (if different
E-Mail
from the Owner listed above)
State or Cou nty License
S :)q I 1 ci
IT value of construction is z5ov 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.