HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I
Date: f ,-2 2- 11 Permit Number: r ^� 1 ALJ
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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 Residential
PERMIT APPLICATION FOR:
PROP®SED fNPR®1/EIVIEIU"fL®CAl`ION;'
Address: `l4 uny ,, dxrtf 2`,id 1-ort pkeme_ I2L 3L S_J
Legal Description:
Property Tax ID#: ( ' "� �J �� JCS Lot No. 2 1
Site Plan Name: 'Block No. ) r 6
Project Name:
Setbacks Front Back:�Right Side: /®,&:a LeftSide:
DETAILED DESS°GR=1PT10N W®RdK;
rG e o L�%e �A � JI/ 6 eo ��or��r�
X31 o��Cs m i )y s eJ
CONSTRUCTI®N I INFOR+NATION:
Additional work to be pertormed under this permit—check all that appy:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: I q o Sq. Ft. of First Floor:
Cost of Construction: $ 2200 Utilities: -Sewer —Septic Building Height:
OWNER/LEyS�SEE: ' CONTRA�'CT®'R: � .
NameC a� C1 /�' �/ Name:
Address: 6704 ,54/74, (f r� /3.1,? Company: er�cue, JA e
City: jzr+ Veil State: 1':L Address: /►t6� S us i
Zip Code: 39 4S I Fax: City: � A el-c-e State: )-_L.
Phone No. Zip Code: y Fax:
Son
E-Mail: Jnn&3S hP_ Cc.nC We Phone No 72<Y&�
Fill in fee simple Title Holder on next page(if different E-Mail
from the Owner listed above) Sta or County License
If value of construction is 2500 or more,a RECORDED Notice of Cbmmencement is required.