HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: ' - Permit Number:
Building Permit Application
Planning and Development Services
Budding and Gale Regulof ion Division
2300 V+r4inia Avenue, Forrt Pierce FL 34982
Phone: (772) 462-1553 Fax- (772) 462-1578
Commercial Residential
CBDG Funding _
PERMIT APPLICATION FOR: -
PROPOS.ED IMP.ROVEI1IENT LOCATION:
Address: ( l J I
Property Tax lD #:
Site Plan Name:
Project Name:
DETAILED ;DESCMPTION OF 1� O- 'K'-. �`" -
L No.
Bl ck No.
New Electrical ML-trq _ Second Electrical Meter {Affidavit required)
CONSTRUCTION INFORMATION -
Additional work to be performed under this permit -check all that apply:
Rechanical - Gas Tank — Gas Piping — Shutters _ Windows/Doors Pond
Electric — Plum bing — Sprinklers - - Generator — Roof Pitch
Total Sq. Ft of Construction: Sq- Ft. of First Floor:
Cost of Construction: $ IaL?,� Utilities.. _ Sewer Septic Building Heig t:
�VMIIVER E E,CONTRACTOR.
Name C1I�
�1 Name_ •r' F
Address:.(! Company; f
City: CC n( Iry vt .State: �. Address.►
Zip Code; Fax: City'
Phone NO. E- Zip Code-, Fax:
Mail: _ - Phone No
Fill In fee simple Title Holder on next page (if different E-Bail 1Lalvvcvvllm.
from the Owner listed above) State or County License
I l �
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 Ncr6ce df Commencement is required,
State: