HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
(~ '1� V12
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:
PROPOSED IMPROVEMENT LOCATION:
Address: bq1 S r. E014 112'! el Ce EL LIQ
Property Tax ID #: � �� 50 j — 0 — 000
Lot No. 10
Site Plan Name:
Block No. 2_
Project Name:
DETAILED DESCRIPTION OF WORK:
T_nSVAX\CkNi0In CS a
` O Cur i<iS a'Yl
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
V/Electric _ Plumbing _ Sprinklers _ Generator _ Roof
Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ i CA Utilities: `Sewer '—Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name: _U `CLY)G � ��
Name V L ,
Address: C C�; t'
Company: —�
City: State:
Address:
Zip Code: Fax:
City: al �' \vs
State: �` L.
Phone No. �� — �Q �1) E-
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Zip Code: i7 �-�1 Fax:
Mail: f \U r jLS
Phone No � — t
Fill in fee simple Title Hoder on next page (if different
E-Mail 1r
from the Owner listed above)
State or County License i
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.