HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: a \`A -D,-a Permit Number:
S``L' LGUL
f c wilding Permit Application
Planning and Development Services
commercial Residential
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR:
D0nP'!ZFn � PROVEMENT LOCATION:
Address: '\
Property Tax ID #: U C), i _ C)c0 r Lot No.
Block No.
Site Plan Name:
Project Named
DETAILED DESCRIPTION OF WORK:
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
,._. P g —
Generator Roof _ Pitch
Sprinklers
Electric _Plumbing — —`
Total Sq. Ft of Construction:
Cost of Construction: $ ' --
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
Namei
Address•v�lZ
City:
�c �F "� _ State: Lr
Zip Code: -- N251 Fax:
Phone No. 5 kg
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
ACTOR:
----------
Name:
Company:
Address:
City:~ State:
Zip Coder Fax:
Phone No
E-Mail
State or County License
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.—