HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date, -J -' � ( Permit Number:
' C L A(-,
Building Permit Application
Plan ning and Development Services
Building and Code Regularion Divk5ion Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34.982
Phone: (772) 462-1553 Fax; (772) 4 62 -1573 CBDG Funding
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address'_
Property Tax I #: - C `
Site Plan Name-.
Project Narne; �
DETAILED -DE CRtPTION OF V4WOR .
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New Electrical I Meter— Second Electrical Meter
CONSTRUCTION INFORMATION,
(Affidavit required)
Additional wo k to be performed under this permit -check all that apply:
Mechanic A _ Gas Tank _ Gas Piping w Shutters Windows/ Doors
Electric _ Plumbing _ Sprinklers Generator Roof
Total .Sq. Ft of Fonstruction,' -- Sq. rt- of First Floor:
Cast of Construction: Utilities: _ Sewer w SeptlE
' 6WNER LE EE: CONTRACTOR:
Name f"
�U-a r n l
Address: Corn pa Y�
an f u ry
City: or l j- C State; ET Address: S- `70,
ZipCode-3qDo Fax: City: Y �
Phone No. E- Zip Code:
Mail' Phone No
Fill in fee Simple Titie Holder on next page (if different E-Mail G1(
from the Owner listed above) State or County Ucen
z
If value of construction is 2500 or more, a RECORDED Notice of CommenE ment is required.
ff value of HAVC is $7,5W or more, 2 RE€ORDED No#ice of Commencement is required.
No.
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Pond
Pitch
Building Heig t'
M r
State_
Fax-
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