HomeMy WebLinkAboutBuilding permit app updatedAll APPLICABLEINF MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �y
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- Building Permit Application
Pbrrdng aof Development Services
&mkfiv and Code Regulation Division Commercial Residential �
23MVirginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
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Address: 6 ' --1 iYt it 4- % 1 ,
Property Tax ID #: :7 / S' C; Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
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New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additi�o al 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: Sq. Ft. of First Floor:
Cost of Construction: $ J, j �- G Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name-T W \j
Name: �0rh-e—+A
Address: 25 FJDY2s v�
Company: - / \r og11C11iIftll16 ECci
may: rsL- State: NL
Zip Code: Fax:
Phone No. Lt ,-, - q 4 �za E-
Address: 31y S �Q,A t-_yVC{C 4
City: State: �L
Zip Code:.Fax:
Phone No
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 ( % I ii S i
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,50 or more, a RECORDED Notice of Commencement is required.