HomeMy WebLinkAboutMadonia app pg 1All APPuCABLE INFO IvlusT BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3-
Planning and Development.Services
Building and Code Regulation Division
Permit Number:
Building Permit Application
Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG. Funding
Residential _ *= _
PERMIT APPLICATION FOR: i|Nqc
PROPOSED IMPROVEMENT LOCATION:
Site Plan Name:
Project Name: tY\4 Acx'`\ C`
DETAILED D ESC IPTION 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
Electric Plumbing _ Sprinklers Generator Roof
Total Sq. Ft of Construction:
Cost of Construction: S ||\2Jq.qto
Sq. Ft. of First Floor:
Pitch
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:CONTRACTOR:
Name Aha t`^Ar]c`\a~Name: MrhehaJ/ H&.Z2))/i.
Address: 3a tmf`prou I i}cL Company: tJtjnfs'+4r /n{_Address:t.3V13£6)fzJmA;h4 & hcc, / ANi
City: `iR_ + J State:EL
Zipcode: 3RAaLsa Fax: ~City: i?zL`m f```j'ju ' State: E
Phone No. I| 7_-J2J`C\-SCH O E-z]ipcode..S±|e£±£±Fax..:111±a±±JJLBPhoneNoli2-Z2`2,-HIV
Mail: u\It
Flllinfeesi+pleTitleHolderonnextpage(if different E-Mail i n fro hf]`tssJ£-Ir7` nc.. C.om
from the Owner listed above)•-. . -- `= ., . ..a
If value of construction ls 2500 or more, a RECORDED N®tice of C®mmencement is requlred.
lf value of HAVC is $7,500 or more, a RECORDED Notlce of Commencement is required.