HomeMy WebLinkAboutBuilding Permit Application (2)All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: � -d21 - 2' 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: Owc+wad- k
PROPOSED IMPROVEMENT LOCATION:
Address: ILil �Je'- Ies
Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK: 1
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New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
,Mechanical _ 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: $ I SyU , Utilities- —Sewer _Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name +-k "I I WLCLfx
Name: Aline¢-br6tY1 - --
Company: '90a1A 1= A -�2r' f1'5e5 =nc
Address: 1 �-`146 SE n '•� i1!
Address: 1115 ttfleS Q [V
City: _ Tc^ ct &Aci% - State: `'F 1
Zip Code: & g 4IS J_ Fax:
Phone No. 595 3ilot 13 E-
City: f off St Lbx i 2 State:
Zip Code: _3N15 Z Fax: 335' 33 fo
Phone No 3q g , nLY4
Mail:
Fill in fee simple Title Holier on next page of different
from the Owner listed above)
E-Mail r JJ dL eyt4r-rerl"SeS e LJ . 66 rnn
State or County License_ C-11A C 11Y 5t4_S9__
If value of construction is 2500 or more, a RECORDED Notice of Commencement is requires.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.