HomeMy WebLinkAboutShaddock.pdfAll APPU? IN~ MUSI" BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ---2.V-g~i, Pennit Number: _____ _
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Planning and Dew,/opmentSetvices
Building and Code Regulation DMsian
Building Permit Application
Residential_/ ___ _ Commercial ___ _
23()() Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (n2) 462-1578 CBDG Funding ___ _
PERMIT APPLICATION FOR: A (:,,. thin
PROPOSEOiMPROVEMENT lOCAltON:
Address:_.L..J_..,_-'--""'-'-"'-'lJ.I.L,µ:,b_,_(=-<-=-"'-<-l-!.r---'-l.,u.:t"--u><:Ll.!...__,/-""-::...1.._,,__,c::c... _____ _
PropertyTaxlD#: i!>03-2H~oo:i.5-oa:,
Site Plan Name: (-mid (t1 Pmds M He lotNo.~--
BlockNo. __
Project Name: ____________________________ _
l DETAILED DESCRIPTION Of WORK:
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New Electrical Meter ___ Second Electrical Meter _____ (Affidavit required)
l CONSTRUCTION INFORMATION: .
Additj<>nal work to be performed under this permit -check all that apply:
'{..Mechanical A{C _ 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: $ 5lJ-QQ . 00 Utilities: _ Sewer _ Septic Building Height: __ _
OWNER/1.ESSEE:
Name (!,..
If value of construction is 2500 « more, a RECORDED Notice of~ is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of eo ... --is required.
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