HomeMy WebLinkAboutBuilding Permit Application (2)All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3 - �L-g' a- ).- Permit Number:
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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: er nt Ck
PROPOSED IMPROVEMENT LOCATION:
'Address: �-d S 2 GS ��V� Parcel `lSo;- -Sa 0 I - d 00-
Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name:
I DETAILED DESCRIPTION OF WORK: 1
o I&k a ` +on 15, S Sec r KlneeIn 6 t&ts l ' '5 sfe
W e0fP_e -ru r 1 t
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
Total Sq. Ft of Construction:
Cost of Construction: $ 5-5-6 Q .
Generator Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name UN kci-WG• l
Address: '�-Os P'e ifics 61VA
City: �� �P1�[.�it - _State: `Fr
Zip Code: 3 qq S''l Fax:
Phone No. 3'q 6 q 0 E-
Mail:
Fill in fee simple Title Holder on next page (if different
Name:
C P-k CVr
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Company: PoJ JL t-:A+iIScS -37AG
Address: I a C! % SE Ti .1a`5-�rr► 1 B l V
City: N & S+- L. u_ct't _ State:
Zip Code: 31-1iS'l Fax: 331§•3310
Phone No 3`�% , a y t
E-Mail Jr _-er1t�+' eretws cke" • cow
State or County License- GMC
1 a-Y 9%I
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.