HomeMy WebLinkAboutBuilding Permit Application - Page 1All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 2 - 3v - a• 1 Permit Number:
V EBuilding 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:$,G�,vt,��
PROPOSED IMPROVEMENT LOCATION:
Address: 1113we' r ley 1J iArce `� ySo� -501 • !S?S-06o-
Property Tax ID #: Lot No.
Site Plan Name: Block No.
Proiect Name:
DETAILED DESCRIPTION OF WORK:
(" a e. o" - 3 +a r. 1 Lf Stag Q
New Electrical Meter
Second Electrical Meter
(Affidavit required)
CONSTRUCTION INFORMATION: 4
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: $ gsoo .cYa Utilities: —Sewer _ Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name
9^111.
Name: 6 ACP, llZ_ (4; V,
Address: KC-4+ V5 91
Company: o �C
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City: I�n!51' Stater
Zip Code: yclS7 Fax:
Phone No. a1 ti- $?I - ! �Sj E-
Address: P-0)(t SE -v.ok +'^i_" la
City:y>r+ 5t- L-kc"Ile" State:
Zip Code: 3gG5-)- Fax: 335 -3310
Phone No 3Q • �3 Liq
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail Oa�d ��� '� Cr)m
State or County License Lov , c Ia. y gi 9 s S
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 requited.