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HomeMy WebLinkAboutLude rose.pdfAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: _ / / — 22 Permit Number: S o LL( L v , agar ix... G °' 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: Address: J D 1 L [A 7 99', ►pLC a1,]\ _ Property Tax ID#: 340Z` 6a / — r/3-3 — (S/�© Site Plan Name: Project Name: New Electrical Meter Second Electrical Meter. (Affidavit required) Lot No. Block No. Additional work to be performed under this permit —check all that apply: N Mechanical _ Gas Tank _ Gas Piping _ Shutters —Windows/Doors _ Pond Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: Cost of Construction: $ zt 2 O Address: f G `1r City: ( rC Zip Code: 3kMz Fax: Phone No. 272 3� z Sq. Ft. of First Floor: Utilities: _ Sewer _ Septic Building Height: State: 4"_ Fill in fee simple Title Holder on next page (if different from the Owner listed above) E Name: C t�, hI, V l C- Company: !,�! / ewe L/ t ilv A) Address: City:FOr-T HtPre State: JE( Zip Code: Z Fax: / Phone No % 7 Z Z� 3 t7 31n E-Mail -1 Uela/%%D(f H 4 (0 ya4-Gty©(-60 State or County License C NC l &6 Z0q 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.