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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED `.i.,-.-` 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 Fundin8 Residential Property Tax lD #: Site Plan Name: Lot No. Block No. Project Name: DETAILED DESCRl.PTI.ON 0F WORK: J fDlri!ries mfrrTr r Can r, C\er .lzJy\ nr)thr\1 fu_ J no / __ -. ' ' New Electrical Meter Second Electrical Meter (Affidavit requi d) CONSTRUCTloN I NFORMATloN : Addjtj;neac[h:::ckai° be perf:raT::nkunderth!S::::::Tn:hecka"ih:::::[rYs: w,ndow!/Doors pond _ Electric Plumbing _ Sprinklers Generator _ Roof Total Sq. Ft of Construction: Cost of Construction: S Sq. Ft. of First Floor: Utilities: Sewer _ Septic Building Height: OWNER/LESSEE CONTRACTOR: I Name` fron \`FenY)Name: k' ifrr`iri iedJ 88 i =bf :,r\Address: ±`) I ffithloc>`F=company:T3if`iinffjiD/ rj}` i j'mf`ha jf¥i 'td.//`Thi `/ th z~'city -len`© Act state:-,Address: i (-Jr* i\JF_ r?ji 3{ j Eff}Th#L# t EL Zipcode:3ltft.S7 Fax: z :,i:;a:¥5:¥aJ,,,#+ Fax, 'State:ELphone No.ila -fiaq~ aaog E-Mail: phone No~| i,.3} - {c?€i ,,a` -E-Mail.p,irSrj/inz=\aciJ(;..a6=ifeF`' Fill in fee simple Title Holder on next page lit different i.,\c¢, &r¥ickyj i . ffJgivy\ from the Owner listed at)eve)stateor€oun-t;LiceFseJf8(`Aa,-;3¥3=3ks74fr y If value of consti.uctlon is 2500 or more, a RECORDED Notice of Commencement is required, lf value Of HAVC ls $7,500 or more, a RECORDED Natlce of Commencement is required.