HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �- �� - I^l Permit Number: Ijo • 0313
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:
PRO `OSED INPR,OUEMENT LOCATION;
Address:
Legal Description:
Property Tax ID#:�3� 19 - E�l G - d Lot No.
Site Plan Name: a Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
N
DEA D RSCRIPTION OF WORK:
-Pen/ Like- Al c e^_-k/_'nr, n'A �-1 +efy kw
acyc
1?4f 1(1(4 6 IA�:j I c.;
CONSTRUCTI®N INF• ATIO'N:
Additional work to be performed under this permit-check all that appy:
VIM _Gas Tank _Gas Piping _Shutters Windows/Doors
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction: $ -31 _I C)O Utilities: —Sewer —Septic Building Height:
OW'NER/LE4-SEE: CONTRACTOR:
Name h6Cr�_A JA; i:e9n Name: roti I Air : Sol��ir 'c�r�_�
Address: q J L1 &J e= QI.eea. 3 e /A ij t Company: ke Z_Ak
City: i @'-etG� State: rl Address: �� 4--N- c='�arnc: L
Zip Code:ZLta1SZ Fax: City: -1=-7 P"e?ic,?_ State: [-
Phone No. 11:17 - 23yl- 05S93 Zip Code: Fax:_-1-)7_ got -!S-3W
E-Mail: Phone No "ll7 - (_3 L o�
Fill in fee simple Title Holder on next page(if different E-Mail C[tni ez;r S.ril 0, � Mcij - G o. Y
from the Owner listed above) State or County License C,/_1 e ig/g66Q
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
a
i