HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
-
V_
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:
I PROPOSED IMPROVEMENT LOCATION: I
Address: :;? . f1d b r u fi S Li '1 fo/f-
Property Tax ID #: C
Lot No. 00
Site Plan Name: Block No.
Project Name: I i J.s C.
DETAILED DESCRIPTION OF WORK:
New Electrical
I
Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit- check all that apply:
(Affidavit required)
_'�echanical _ Gas Tank _ Gas Piping _ Shutters Windows/Doors Pond
-Electric _ Plumbing _ Sprinklers V/ Generator _ Roof Pitch
Total Sq. Ft of Construction: 2
Cost of Construction: $ / 3, 9LOg
Sq. Ft. of First Floor:
Utilities: `Sewer _ Septic Building Height:
OWNS LESSEE:
CONTRACTOR:
Name : c.L I
Name: `
Company:
Address: bar-
Address: 6M tW roh -s Gtq
City: ce- State:
_
Zip Code: 2K y W:;L- Fax:
City: C 4 State: 1`7—
Phone No.'s c� t E-
Zip Code: 34Q:J`? Fax:
Mail:
Phone N
e-YL( Sa2':'D
E-Mail
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
State or County License B:'('-S
IT value OT construction Is 25UU 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.