HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3 - a$ ' a� Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial
CBDG Funding
Residential
PERMIT APPLICATION FOR: mt
PROPOSED IMPROVEMENT LOCATION:
Address: ) 0 3 1 1e5 6 Naarse -:51 'q5a a -50L 19- 000-
cl
Property Tax ID #: Lot No.
Site Plan Name: Block No,
Project Name:
DETAILED DESCRIPTION OF WORK:
A, 3 -�vv� ....1.._ Seep ire s+ coo i m -e
i1 tpu '
New Electrical Meter
Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
Electric _ Plumbing _Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 5oU . �_
(Affidavit required)
Generator
Sq, Ft. of First Floor:
Windows/Doors Pond
Roof Pitch
Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name KC etk 11
Name: uAiNce Gar
Company: rp
Address: Jiai b S r Th
i h
riw --C^c
,- -+read 91v
Address: O e+i vJ
City: Tep5 &L-CA Stater
Zip Code: 34 9 S -1 Fax:
Phone No. `7 � j�' - E-
City: I" d f-�- Sim '"'Aci e_ _ State:
Zip Code: 3 `19 5 ;), Fax: 335 - 3310
Phone No 391" '�L3 4
E-Mail / .)dtA-_,e�r Q f 1'ses d . C im _
State or County License 'e me 1 a Lr c 4 rg
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
If value of construction is 2500 or more, a RECORDED Notice of 4ommencemem: is requIrea.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.