HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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:
PROPOSED IMPROVEMENT LOCATION:
Address: W3 caek oWsAe
Property Tax ID #: 3327" 503 - 0o5 If - 0o -0 Lot No. 12
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:
Additional 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: $ 1 I '-500 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name W (A)la tgZ4'1
Name: h k10✓
Address: _bC21% VQ&Q, IX;-'
Company: 3 C
City: "ems State: —rk
Zip Code: ?5A k Fax:
Phone No. E-
Address: G &)LO D QOc
City: P C State: R&
Zip Code: Yqa C Fax:
Phone No -77o2 --7'T%-00/ v
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 oC
�a��„�., u��wn In.cwo or more, a KtLUKutu Nonce oT commencement is required.
If value of HAVC is $,7,500 or more, a RECORDED Notice of Commencement is required.