HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
�i 7 01,
vv E T Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial
CBDG Funding
PERMIT APPLICATION FOR: HtIAI, — AC
PROPOSED IMPROVEMENT LOCATION:
Address:
C#�an. 1-)r, 0
Residential Yes
Property Tax 1D#: 332A�- „ 09--o1y2,'cw--q Lot No.
Site Plan Name: Cos l tcR n=e s (In_ a : n : or:)n Block No. 3&S
Project Name:
DETAILED DESCRIPTION OF WORK:
New Electrical Meter Second Electrical Meter_ AID (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
YMechanical , Gas Tank — Gas Piping
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ �2i
Shutters
Generator
Sq. Ft. of First Floor:
Windows/Doors Pond
Roof Pitch
Utilities: —Sewer —Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name TY' .
Name: V cjho tYl
Company: � jI r
Address: f C& &L &z. ij
Address: q-,z iA?i r^j )i 1, c e3tg Or, 4 �3D2S
City: RF- r)t Yew State: FL,
Zip Code: 13W9000 Fax:
City: ife rp &&b _ Stater
Phone No.qa I D - Q�55 E-
Zip Code: ° 2 ,� Fax:
Mail:
Phone No '
Fill in fee simple Title Holder on next page (if different
E-Mail i—�' •�
State or County License A 130 to- A) I q
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.