HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: j a' 13 - �-� Permit Number:
LL 1CLL
r Building Permit Application
Planning and Development Services
Building and Cade Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR:�� y 1
PROPOSED IMPROVEMENT LOCATION: [
Address: i 5� OcH e5 D1vA kr4fe 501- 03Y A - 000 - o
Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
OcA 'A +or, I eec Rh ee -� Goo �
'9kW r (; e Pvir Ii(ce
New Electrical Meter
Second Electrical Meter,
CONSTRUCTION INFORMATION:
(Affidavit required)
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: $ 5-K0 o . Utilities: _ Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name MaLvizekl
Name: \406\ [ 9 Cotr i to
Address: I 6 [Je�ieS
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Company: od r'� t
City: r
Zip Code: 3` 51
Phone No. D
State: _
Fax:
KS YE
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: ;L sE k L
Addre�10174'5+
City: i- M-Ct'G
Zip Code: 349!�;L — Fax: 3
Phone No --,,-3q t
State: 1
3 0
Mail:
Fill in fee simple Title Holder on next page (if different
from the owner listed above)
E-Mail FddeA e4l+eY-R0 SJ5&D
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State or County License C iN`G [ 7-L161
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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.