HomeMy WebLinkAboutBuilding Permit Application (2)All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7 - .i `i ;l x Permit Number:
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9_7"MMMOP., �`` �" 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:
Address: Clq S 15CA�1,5 9 WA Va&tl T�_ -56 1 - III 04>0.
Property Tax ID #-. Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
C-An o Kt a 'A - vtx I q Seer "J"e S co L"n
I0 4Kuv hca+er lr'k?, -Gr lr(.e -
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: Sq. Ft. of First Floor:
Cost of Construction: $ �.1� l -V 60 v a Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Sew ra i aA
Name: v C fl- co r'n
Address: q'15' V J,
Company: 00ij GA+elr �►3es _i lc
City: :37pASen State:'P(
Zip Code: M151 Fax:
Phone No. O E-
Address: I %9 (a Sk
City: f7ort uxcr e State: 11'" 1
Zip Code: 345 5;L Fax: 339,33 1 o
Phone No APfLf
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
1301
E-Mail et te-Cp • Se5 o • com
State or County License
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-