HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: _______ _ Permit Num ber: ________ _
Building Permit Application
Planning and Development Services
Residential X Building and Code Regulation Division Commercial-----------
2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462 -15 78 CBDG Funding -----
PERMIT APPLICATION FOR: DINSMORE RESIDENCE
PROPOSED IMPROVEMENT LOCATION:
Address: 1625 EASY ST, FT PIERCE, FL 34982
Property Tax ID #: __ 3 _4 0_2_-_6 _1 0_0_-6_3 _0 _-o_o_o_-1 ______ I_R_E _U_N _IT_9 _________ _
Site Plan Name: __ D _IN_S_M_O_R_E_R_E_S_ID_E_N_C_E _________________ _
Lot No. 36 ----
Block No . 92
Project Name: _S_I_N_G_LE_FA_M_IL_Y_H _O_M_E __________________________ _
I DETAILED DESCRIPTION OF WORK:
3.2.2 SINGLE FAMILY HOME
New Electrical Meter __ x ___ Second Electrical Meter ______ (Affidavit required)
I CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
�Mechanical
� Electric
_ Gas Tank
�Plumbing
_ Gas Piping
_ Sprinklers
_ Shutters
_ Gen erator
� Windows/Doors _Pond
iRoof __ 6 _/l_2_ Pitch
Total Sq. Ft of Construction: _3_0_0_6 _____ _ Sq. Ft. of First Floor: __ 3_0 _0 _6 ______ _
Cost of Construction: $ 3 os,OOO Utilities: _ Sewer � Septic Building Height: ___ _
OWNER/LESSEE: CONTRACTOR:
Name DANIEL & LAURA DINSMORE Name: MARK MONTALTO
Address: 6106 SUNSET BLVD Company: PSL PROPERTIES, INC
City: FT PI ERCE State:� Address: 201 SW PSL BLVD
Zip Code: 34982 Fax:________ Cit y: PSL State:�
Phone No. 772-336-0050 E-Zip Code: 349 84 Fax: ______ _
Mail: _ _,;_ps_l'--pr_o..:...p_l_@..;::g _m_a_il_.c_o _m _______ _
Fill in fee simple Title Holder on next page (if dif ferent
from the Owner listed above)
Phone No 772-336-0050
E-Mail PSLPROPl@GMAIL.COM
State or County L icense_C_B_C _12_6_3 _0 _7 _2 _____ _
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.