HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3 " �� - �-)' Permit Number:
`141 ;Y,Qt.(' .
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1SS3 Fax: (772) 462-1578 CRDG Funding
PERMIT APPLICATION FOR:���! �� 1
PROPOSED IMPROVEMENT LOCATION:
-Address: g6-7 '"e e_5 giod, fare -el ::rJ Lf50a-501 - 09P13-GD0--(3
Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK: I
ft4- 3 Iron 1 `f she r CsrA►.d a. k M. 5+ cap I Ltyk �� �- 15 C- w
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit- check all that apply:
_Mechanical _ Gas Tanis _ Gas Piping _ Shutters Windows/Doors _ Pond
— Electric _ Plumbing T Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 5 0oo .ao
Sq. Ft. of First Floor:
Utilities: —Sewer _ Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name 1QCkA Q'Af025Ae_
Name: \)A-1\Ce IZ Cod i'n
Address: 742'7 +Ne leS 914
Company: 0oA Et_+,er r,'
City: 4u, se^ &.c State: i`t
Zip Code: 3�957 Fax:
Phone No. Sng - �7�1 - 5�1'T q E-
nn
Address: � a �? (� `�L �n s�-�f'�a � � I V dL
City: for+ Sk Lwz e_ State: 4:5(
Zip Code: 3 �{9 5 X Fax: 335 • 33 Jo
Phone No 39'S - a 31q
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail oQJJJ • Ct)yft
State or County License Cl►tiC 1 7.4 9 q 5$
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.