HomeMy WebLinkAboutPage 1 10105 Spyglass.pdfAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number:
Date�I
I I-1
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U I' F: "-" 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 LOCH ON:
Address:Jn
Property Tax ID Lot No.
Site Plan Name: �. /LW.—ck No.
Project Name:
DETAILED DESCRIPTION OF WORK:
t
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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
Electric )� Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ Utilities: -Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRA R:
Nam
Name:
Ad S
Compan
City: State
Addr
City: State:
Q
Zip C de: 'rrl Fax:
Phone No.% 7� —���-R i E-
Zip C de: Fax:
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Mail:
Phone No
Fill in fee simple Title Holder on next page (if different
E-Mail
State or u ty License
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.