HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAl I APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: L. Permit NLimber.
.. U-I_C. LL...
_ Y Building Permit Application
Pianning and Development Services
Brriiding and Cade Regulation Division Commercial ate S i d en tlal
2300 Virginia Avenue, Fort Pierce FE 34982
Phone- (772) 462-1553 Fax: (772) 46 2- 15 78 CBDG Funding
PERMIT APPLICATION FOR: - PROPOSED IMPROVEMENT LOCATION:
Address: �je7Fli /`- ,/]�] 2
le
Property Tax ID Jt- i+ i/ ( z ` +�r a
Site Plan Name: f
Project Name,. (ro T sI
DETAILED DESCRIPTION OF WORD{:
New Electrical fuleter Second Electrical Meter (Affidavit required)
CON TRUCTION INFORMATION:
No. _.
k No.
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 I Pitch
Total 5q- Ft of Construction: Sq. Ft, of First Floor:
Cost of Construction. (oc 1 Utilities; _ Sewer _ Septic
OWNER/LESSEE:
N rrl--rr o I r ..or tv
Address: f W
City: State'
Zip Code: Fax:
Phone No. 19�c
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
CONTRACT R:.
Name:
_ Company-. nr l(
Address:
City' to r
E- Zip Code:
Phone No
E-Mail wW
State or County License_
If value of construction is 2500 or more, a RECORDED Notice of CcPtimen cernent is required.
If value of HAVC is $7,500 or move, a RECORDED Notice of Commencement is required.
Building Heigbt'
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state:
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