HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
bate: 1 "a?- �';[- Permit Number:
LLaL .
Building 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: M jd �,'ca_(
PROPOSED IMPROVEMENT LOCATION:
-Address:
5"7eit le,S 61 J, as j'G.e( Z J * 143'0 ,)- S'o l - 0769- 000 - I
Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
C ae_ o a_-+- 3 +on l q seer VaAAvte 5-� coo ( Di::A LtAi.I-. 10
New Electrical Meter
Second Electrical Meter
CONSTRUCTION INFORMATION:
(Affidavit required)
Additional work to be performed under this permit -check all that apply:
_Mechanical — Gas Tank —Gas Piping _ Shutters
__.. Electric _ Plumbing — Sprinklers _ Generator
Total Sq. Ft of Construction:
Cost of Construction: $ 5 d
Windows/Doors Pond
Sq. Ft. of First Floor:
Utilities: ^ Sewer _ Septic
Roof Pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name C4.44+,Ct 05+"0
Name: \iGv11G?, iZ Cor 1•V\
Company: Dock(k eft- 'er TrSG5 ;Qic,
Address: 57304ftk 61J
City: TP_A5 4N __ State:a
Zip Code: 3 ifCJJ Fax:
Phone No. -11L 3 - q o q a E-
Mail:
Fill in fee simple Title Holder on next page (if different
Address: 0-156 61-6ri .I 131t1
City: f O i'i" St- LL-4_f.. _ State;1
zip Code: 34 0 5a Fax: 3355- 33 I D
Phone No ` C14911 '' - 3344
E-Mail �OCU 211.'rGf `�g'f�S • �'�YY►
from the Owner listed above)
State or County License GI'1/1C ) 2��qq
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.