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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE, 6WF® R6U,(�ff BE CGMFL[�-a00) FOP, APPLUCATOO 2 70 DE ACCEPTED Date: Permit Number: • Pei° oR App aC U0) R Planning and Development Services Building and Code Regulation Division 13W Virginia Avenue, Fort Pierce FL 34981 Phone: (772) 462-1553 Fax: (772) 462-1578 CornnnercW ReSIdentia t PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION: l Address: Legal Description: ('S Ccs Property Tax ID #: :3 L.(J f — :5�^lCD —()()-3L' C)C) — Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: —c,ecK an rlanoiv: i3HVAC LJ Gas Tank ❑Gas Piping Electric Q Plumbing RSprinkiers Total Sq. Ft of Construction: Cost of Construction: $ 761 _ LJ Shutters 0 Generator Windows/Doors CRoof SQ. Ft. of First Floor: Utilities: Sewer ElSeptic Building Height: OWNER/LESSEE: CONTRACTOR: NameOYAn Name to Addres • C ca C cin,-. �''' Company:'W --�• �' 6 r��l a t • •- City: � �-� State: 6� T Address: Zip Code: ``t Fax: City: • e rr-[ Stater Picone No. `7 t CD Zip Code: 3,-t,:?,zFax: E -Mail: Phone No. (4 ca L( or Fill in fee simple Title Molder on next page ( of different E -Mail: c z , -"C- Cc-bpJ `A 1I c fyam the Owner listed above] State or County License: C IF51 3 (e it value or construction nz�zsau av hiam, a RECORDED WoUce of Commencement Is required.