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HomeMy WebLinkAboutBuilding Permit Application All APPLICA/BLI�INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED `� �2( j Date: �l 1' l -7 PermitNumber:_ , `1 'c'ba 0 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 Residential PERMIT APPLICATION FOR: f�l,n C Y PR®POS,ED .JR,_Q LOCATION: Address: 1310 /V Near, I aye PSL_ y�� �3 q?C'3 Legal Description: Property Tax ID#: 3L11 5— S-3 DPD 2 5 — 0yO^ S Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: D'El"AILED ©ESC-Ali TION 'OF�V1/OR�K; ' �/'L iia�N ��e c�f�1� S F-C ewe =WNSTRUCTIO.N IN O ATION Additional work to be performed under this permit—check all that app y: - _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Electric _Plumbing _Sprinklers _Generator _Roof Total Sq. Ft of Construction: / Sq. Ft.of First Floor: Cost of Construction: $ / Utilities: —Sewer —Septic Building Height:. .,� 7'+ )" _tet" � � l/i -,Name ;�� l<i{t!IGth�7 s a��+Name ,: a+p�r, .�l'� 1� Lam: Address, </3� IV• G�VT152 C �� {`Company: W (ii/IS47/'GtC o i) City: �SL' l/1 state:_ "Address.::" 1::°g .-. W_- Zip Code: Fax: // City: '3'� State: L Phone No. -772-- Q7 6 Z�S Zip Code: _34M 10 Fax: E-Mail: ►r /I Cult 4!SMA' ) � ed� Phone No c72— ZSU, � cF5_57 Fill in fee simple Title Holder on next page (if different E-Mail LVI 2�A VLA e��� Co from the Owner listed above) State or County License C If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.