HomeMy WebLinkAboutbuilding permit application- st. Lucie County2All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 01 I 04 I 202.Z.Permit Number: _______ _
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Building Permit Application
Commercial )< Residential
Planning and Development Services
Building and Code Regulation Division -------------
2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding ___ _
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: ��79 '?r� }v�
Property Tax ID#: 2312-144-0003-000-8____________ Lot No. ___ _
Site Plan Name:-------------------,-------- Block No. __ _
Project Name: 111v f e-k, Qo,c \f\W\ f,t""" f<.tA�
New Electrical Meter � Second Electrical Meter ....... t-t...,./�A: ........ ___ (Affidavit required) I 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 Roof ____ Pitch
Total Sq. Ft of Construction: ::4:, �4-<., c.P Sq. Ft. of First Floor: \? 1-C::,'?'2 ��.
Cost of Construction:$ � ,ax>Utilities: �Sewer _ Septic Building Height: ___ _
OWN ER/LESSEE: CONTRACTOR:
Name__._��fi,....-.J-,:.;:_,::;=....a....:'---------Name: ti\,',;+ M��LL,.
Address: �l S. S\::z.l\c:., f2& :f:Company: Qi�� s eiv, l �b U,,-f ·City: ft:. \µApzlid.c., State: _fl-Address: (pQ;Q SW ?"91-�
ZipCode: ���\-, Fax:________ City: QA\/\(.., State: F-l-
Phone No. 'a.!54) �04- - � E-Zip Code: 3�� 14-Fax:--,-------
Mail,jtae!-U?:lt e�ek,.,�e,. LOIV\ Phone No l�-s4-) S(p�-�c,�
Fill in fee simple Title Holder on next page (if different E-Mail f\'\ ,vle,\rra LG. �• � '¥'-\.l.c,o. GP/ll'I
State or County License f:1 -e: (.b(, o4-o\D8 from the Owner listed above)
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.
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