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HomeMy WebLinkAbout38loslagos3All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: lo� - 8 -;!�n Permit Number: Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial CBDG Funding PERMIT APPLICATION FOR: PROPOSED IMPROVEMENT LOCATION: Residential V Address: ` � �C �� [ i (=,t� a! is ' Rein+ 3 FL -31-6 52 Property Tax ID #: Lot No. Site Plan Name: Project Name: Block No. I DETAILED DESCRIPTION OF WORK: I New Electrical Meter Second Electrical Meter CONSTRUCTION INFORMATION: Additional work to be performed under this permit- check all that apply: XMechanical _ Gas Tank —Gas Piping _ Shutters Electric _ Plumbing _ Sprinklers Total Sq. Ft of Construction: Cost of Construction: $ 6. y(b �!5 , Q<) (Affidavit required) Generator Sq. Ft. of First Floor: Windows/Doors _ Pond Roof Pitch Utilities: _ Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name 'T C 1� S N �t Name: Ca-� Ca fl-A aj��1 Address: :5 Z ,3 t iat�c tJ Company: C cell City: a',C4 y5�` CoC e State: Fe- Zip Code: 3gcj, Fax: Phone No. des _:;- :S-5c) E- Address: ��12`-SL` ��1tsJ �� t,g �az. City: i. Zip Code: Phone No 77�; State: Fax: Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail C'g�ty ph�i� CcSt l � 1 o oil �r� tti State or County License � C cac lSz_ 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.