HomeMy WebLinkAboutBuilding Permit applicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3. 3 " ;L;-- Permit Number:
LL
U _. Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce Ft 34982
Phone: (772) 462-1S53 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR: ry�tCJ,,,X1 Co, [
PROPOSED IMPROVEMENT LOCATION:
Address: a l�L l�S 61vA G c of
Property Tax ID #:
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
56 '� - 5U1- 05'07- 000-,5'
Lot No.
Block No.
n 1 See Glf'a ire 5�- u-
n K tiJ h �►. e l� K� -� r i g kQ
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
(Affidavit required)
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 Pitch
Total Sq. Ft of Construction:
i
Cost of Construction: $ $ Od
4 OWNER/LESSEE:
Sq. Ft. of First Floor:
Utilities: `Sewer _Septic
Name r ' oe 6f'oo f
Address: 3�1 K&W5 G1
City: ;r & State:/
Zip Code: - 3 Y S7 —Fax:
Phone No. (�. 6' -363 E-
mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
CONTRACTOR:
Building Height:
Name: VQnt 11 K Corb;A
Company:P152SC-
Address: ?^ (0 5� �n S-� Ti'� &IV
City: b f 5 r I.. k C,'e State:
Zip Code: ,3� _Fax:—)3571331Q
Phone No '9 3
E-Mail � en�c�' !'a'StS OgL" Cd nn
State or County License_ CIVIC)
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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.