HomeMy WebLinkAboutBUILDING PERMIT APPLICATION page 1AIIAPPTICABIE INFO MUsT BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:Permit Number:
Building Permit Application
Planning ond Development Services
Building ond Code Regulation Division
2jA0 Virginio Avenue, Fort Pierce FL i4982
Phone: 1772) 462-1553 Fax: (772)462-1s78
Residentia | \'/Commercial
CBDG Funding
PERMIT APPLICATION FOR: fu. N {Lu,_ t',Lcc
PROPOSED I M PROVEM ENT LOCATION :
Address: - l?0\ St",r*:,n ,tl .,4, (a-l= ?jc--.c- % a\,3,'? ? . - .
propertyrax rD #: ?-(( I'al\ - \oOLl - OOO - g Lot No._
Or.af etgSite Plan Name: EIock iv6.--
Project Name:
DETAILED DESCRIPTION OF WORK:
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION I NFORMATION :
Additional work to be performed under this permit - check all that apply;
_Mechanical _ Gas Tank _ Gas Piping
_ Electric _ Plumbing -- Sprinklers
TotalSq. FtofConstru.tionr [7 ?6
_ Shutters
_ Generator
Sq. Ft. of First Floor:
Windows/Doors _ Pond
X Roof 1/tLpitcn
Cost of Construction S LO ,7O Cl Utilities: _ Sewer _ Septic Building Height: t7
lf value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
lf value of HAVC is 57,500 or more, a RECORDED Notice of commencement is required.
OWNERILESSEE:CONTRACTOR:
rurr"l_q.-4.ig -e" " Ai
Address:
City:l4A- Oi crcc State: E
Zip Code: 3jttS ( ra*,
Phone xo.? 7Q--1o8 -?noc> - e-
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Name: Niol,vlL..> 4trLc"
Address:
city: (2o-E $+ LtCc-State: Pl-
Zip Code: 1Y-\82 rax:
Phone t'to 2?)-e43-- 0c+6 X
E-Mail ?or).iC7 r.. e-i yi C-l Q g ,*.ii.q,",,
State or County License Lc<- LlnTLnt
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