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BUILDING PERMIT APPLICATION
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: P` ! � � ®' 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 Fundinga �' �'� �'�� b PERMIT APPLICATION FOR: Address: ->v't `� � W*,n �V o 6s, 1- Property Tax ID #: _, ©`� _ D /•-- d 6 d n 6' d Site Plan Name:-5�y,'! IF Project Name: -.L- - r,9i%PV New Electrical Meter L,� Second Electrical Meter (Affidavit required) Lot No. Block No. Additional work to be performed under this permit -cheek all that apply: :::'_'<echanical —GasTank —Gas Piping _Shutters +Windows/Doors _ Pond 141ectric —Iriumbing _Sprinklers `:Generator _ Roof Pitch Total Sq. Ft of Construction: _/ � Sq. Ft. of First Floor: 1' Cost of Construction: $ d n Utilities: —Sewer —Septic Building Height: Name. ( Address; City: — 4:i� State: Zip Code: Fax: Phone No. E- Mail:------ Fill in fee simple Title Holder on next page (if different from the Owner listed above) Name: Coompany.af?� Address: _ of & City: 7— ei- State: ` Zip Code: T 5 K Fax: Phone No E-Mailc�.rs�. CCU-yim�utC.Cos,: State or County License i /—/ If value of construction is 2500 or more, a' RECORDED Notice of Commencement is required. If value of HAVC is $1,500 or more, a RECORDED Notice of Commencement is required.