HomeMy WebLinkAboutBUILDING PERMIT APPLICATION " All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number.
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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: S6 QJ (2 e: t,V,
Property Tax ID#: 33 off'-<0�.5"���'�-�yy`� Lot No.
Site Plan Name: )o- "\ey Block No.
Project Name: �C�v. `9L
DETAILED DESCRIPTION OF WORK:
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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 ZRoof Pitch
Total Sq. Ft of Construction: OZ� Sq. Ft.of First Floor: at(0o
Cost of Construction: $ moo Utilities: —Sewer _Septic Building Height: 1-2-
OWNER/LESSEE: CONTRACTOR:
Name 30► C Name:,-T�kv..�,v.v. �Y--
Address: `-. Company:Soln v. �;C'A..w.vww'
City: State:� Address:7%i C;;�'�cis %x,
Zip Code: Fax: City:-:7o 7 9c' 2,6'-1 Q, State�5!L
Phone No. E- Zip Code: Z&-9V Fax:
Mail: Phone Now 7Z-
Fill in fee simple Title Holder on next page(if different E-Mail
from the Owner listed above) State or County License q 4 .I
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.