HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3 ` I q— �, P- Permit Number:
nF11 LL1:
0
T-7-0=7
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-15S3 Fax: (772) 462-1578
Commercial
CBDG Funding
PERMIT APPLICATION FOR: 2G.nCa
PROPOSED IMPROVEMENT LOCATION:
Residential
ly—
-Address: 10 7 a S S. O C 4n 0r
Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name:
� DETAILED DESCRIPTION OF WORK: I
o u -r 3 +u in I � s-cenr 1 rn Alo,.}Ire 5+ cm 1 o ka u4-,;
D w c r
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:
Cost of Construction:
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height,
OWNER/LESSEE:
CONTRACTOR:
Name �af+R{5 �rC'a
Name: CDI101A
Company:
Addres
Address: (} 2S .S. 0Ce0Vw Af a}
City: i^ 5 State: 1
Zip Code: 3� R 571 Fax:
Phone No. 73 -SAY __ E-
City: T6 LLL e-4 e State:
Zip Cade: a915 2- Fax: 335- 3310
Phone No
E-Mail
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
State or County License CAC r aLMJ
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.