HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INF9 MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: i g U` Permit Number:
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F Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial _
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR:
Residential
V
PROPOSED IMPROVEMENT LOCATION:
Address: L 6
Property Tax ID #: S 54/ l Lot No.
Site Plan Name: Block No.
Project Name:
I DETAILED DESCRIPTION OF WORK: I
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Addal work to be performed under this permit - check all that apply:
7echanical _Gas Tank _Gas Piping _Shutters —Windows/Doors _Pond
_ Electric _ Plumbing _ Sprinklers —Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ Utilities: —Sewer _Septic Building Height:
OW N ERAESSEE:
CONTRACTOR:
Name-rON\j e� to
Name: W,YK D-- TGYn-t%1C-
Address: Z5 Fl u) ff> 1,�a4
Company: HC ICry )�11
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City: iSL State: FL
Zip Code: Li S� Fax:
Phone No. E-
Address: S'ly !3W 52i,� 1 LdQLf
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City: Y �L
Zip Code: 3L4 6 S 3
Phone No
State:L
Fax:
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
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State or County License C, k 4 14.%S I JT
If value of construction is 25M 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.