HomeMy WebLinkAboutBuilding permit app, pg 1All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ! t ; D - t Permit Number:
; �L��QL
c 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: 14401- f.iir4 Av F01-1 Ike t ktt J:' L 4cii )
PropertyTax ID#: t307 8 ig 0 OJLiO 00,0 q Lot No. 1
Site Plan Name: Block No.
Project Name:
z- 3 V-V" u 14 f oI. L,
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: itoj R Sq. Ft. of First Floor:
9^
Cost of Construction: $ 1 O.r L5` 0 " Utilities: — Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name L' �'J V-JJ t e '7* "iit A.-
Name: '&-ver : ,kie3
Address:"74 01 "A -A A✓
City: ill o-ki P, f.1-ee- state.",:,-
_
Company: fApeS AA (-Iep,-7 iL LC_
Address: "o0J Uo`� °` Sl
Zip Code: '3- l 1 Fax:
Phone No. `�, a d ii 3-5S-1 E-
City: ���rta &L.,L, State:
Zip Code: 31.17'Loo Fax:
Mail:
Phone No -Ill Sicl 031 a
Fill in fee simple Title Holder on next page (if different
E-Mail �iL�z>nJ (j/��5t�c�l t�.rPt�9i Ufa _
from the Owner listed above)
State or County License &"), Imo, Os-'q 2
VO UC %.W1ML1 uLAJUF1 i, cavv or more, a KtwKutu ivotice oT commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.