HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3 - / 1- ;)- Permit Number:
" 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: rntck( �I
PROPOSED IMPROVEMENT LOCATION: 1
-Address: _ a s f\�+H eS 61'A P&ra l -VG`
Property Tax ID #:
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Ke-
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
Lot No. —
Block No.
Windows/Doors T Pond
Electric _ Plumbing _ Sprinklers _ Generator _
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
ev
Cost of Construction: $ t`f q O0 . T— Utilities: —Sewer _Septic
Roof Pitch
Building Height-
OWNER/LESSEE:
CONTRACTOR:
Name e5
Name: Va.gCe K C,or b#'n
Address: m fC �e5 Ry _
City: S nsem State: 4�1
Zip Code: 34551 Fax:
Phone No. �-v�(- 1-1 37 E-
Company: V o
rY S G
Address: (�-916SE �n 'a � glv
City: Pork LIA-CifState: fL
zip Code: 3YCJ5a Fax: 33S 3310
Mail:
Fill in fee simple Title Holder on next page (if different
Phone No 361- a Y
E-Mail dJ em-�t-f r, 5ts
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State or County License C!h C 17L
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from the Owner listed above)
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.