HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: — Permit Number:
P Il c 1� c L" 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:
Property Tax ID #: ,4`J(M —
Site Plan Name:((`tlfJi�
Project Name:
DETAILED DESCRIPTION OF WORK:
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit — check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $) , d
(Affidavit required)
Generator
Sq. Ft. of First Floor:
Lot No.
Block No.
_ Windows/Doors Pond
Roof Pitch
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
Name:
oLXJ
Address: s:�
City:'\ State: ls�(
Company:
Address: ^_
Zip Code: �j Fax:
Phone No. ��{�� 'CDC- -U�� E-
City: ,
Zip Code: 3 C
5 ate: FL
Fax:
Mail:
Phone No ( la
-
Fill in fee simple Title Holder on next page (if different
E-Mail
A-n-) -
from the Owner listed above)
State or County License LE
—
VU — W w4la I ULL Un i'1 LJUU Ur TTIUre, a nCLUKUCU immice OT GOmmencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.