HomeMy WebLinkAboutapplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: i ` 23 . i-X Permit Number:
Building Permit Application
Planning and Development Services
Building and Cade Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
9
PERMIT APPLICATION FOR: I \eJwLA
PROPOSED IMPROVEMENT LOCATION:
Address: 3-xq ►Jeikk,!5 SIJ Pa.1rcel 056- 0,00-_q
Property Tax ID #:
Site Plan Name:
Project Name: _
DETAILED DESCRIPTION OF WORK:
Lot No.
Block No.
e. 3+ seer re_ st to w & -e
It Ke 4; r l4
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
Electric _ Plumbing _ Sprinklers _ Generator
Windows/Doors Pond
Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 4 8 00. Utilities: —Sewer —Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name A
Name: Va.#\c2iZ Co
Address: 37-�1 >nie-k4 (�5 i3i�/
Company: 'y J GAie rrSeS
_
City: _YZASA^ & State:4,1
Zip Code: 34qFax:
Phone No. 10 - SS 07 E-
Address: i �0 b S E f i&
City: ac±:!�k LLL,r e State:
Zip Code: 34q51 Fax: 331; -33) o
Phone No M 9 - X3 4L(
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner Fisted above)
E-Mail e41_+QW-'r'U56'0• C0^
State or County License CAC 1 ;04
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.