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HomeMy WebLinkAbout2022-03-11_204536 All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: c c c c = Building Permit Application / Planning and Development Services Building and Code Regulation Division Commercial Residential y 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 CBDG Funding PERMIT APPLICATION FOR: PROPOSED IMPROVEMENT LOCATION: �, L Address: 7 V Ma. fah u'P q l/T Property Tax ID#: 33dA " ) 3 Pal — 0©O Lot No. Site Plan Name: Block No. Project Name: DETAILED DESCRIPTION OF WORK: -er�l4ca,w�e�� ac Y©gal -6e-u Ck'c- uJ0,4R-R. ,eat 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 Pitch Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction:$ 1 I !boo Utilities: —Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name S W s Name: Q vt yQ�� Address: 76 h � C Company: f-0900 ! , /-- City: VkQ L-Ik 9 State: 'FL Address: Co q � Zip Code: L(Q 8 Fax: City: e !Ct2 State: r�- Phone No. E- Zip Code: Y9Y6 Fax: Mail: Phone No -779 ` 7-7 /�7— 00/0 Fill in fee simple Title Holder on next page(if different E-Mail (?tt W(ZCi�J%'A C O O CrO vrn. from the Owner listed above) State or County License CT-C ( l_q 0 e q 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.