HomeMy WebLinkAboutJ-Permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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' Building Permit Application
Planning and Development Services
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Building and Code Regulation Division Commercial Residential
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2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR:
FRfiIOi # �T LQCAT01 f i. Ith f'�
77
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Address:
Property Tax ID #:
Lot No.
Site Plan Name:
Block No.
Project Name:
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New Electrical Meter Second Electrical Meter (Affidavit required)
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fii t �7 ON INFORMATION:
Additional work to be performed under this permit- check all that apply:
Mechanical " Gas Tank _ Gas Piping _ Shutters Windows/boors _ Pond
Electric , Plumbing ^ Sprinklers _ Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor: —
Cost of Construction: $ � -1 G Utilities: _ Sewer ` Septic Building Height:
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Name v�� lf_�,Y, J ��,'���'�c �' Name: i'or �r�1-�7v,C► �; �J,l rY_L/.�`::
Address• A U Cx/V"N L c`-)CC company: 0+l-CAr'%RP ��-
City: 1'C'i+State: Address: " 7_' .-0 (-) a " 1 t-- �.^ �✓
2';'i L S Z= Fax: city: ` +� �' r � �' ��' State
Zip Code: ty:
Phone No. E- Zip Code: "� ` `1 �'�� Fax:
Mail: Phone No
Fill in fee simple Title Holder on next page (if different E-Mail
from the Owner listed above) State or County License
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
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If value of HAVC Is $7,500 or more, a RECORDED Notice of Commencement is required. C
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