HomeMy WebLinkAboutpermit applicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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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: Plumbing
PROPOSED IMPROVEMENT LOCATION:
Address: _ SU r l1-ompson O I n't L
Legal Description:)
L/
Property Tax ID #: 3 7- 70 1 y 00 7 ` o((O_ 7 Lot No. 926
Site Plan Name: Block No.
Project Name:
Setbacks Front Back:
Right Side: _ Left Side:
DETAILED DESCRIPTION OF WORK:
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CONSTRUCTION INFORMATION:
Additional work to be per o rmed under this permit- check all that appy:
HVAC 0 Gas Tank []Gas Piping Shutters E]Windows/Doors
Electric � Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ _50
Sq. Ft. of First Floor:
Utilities: ❑ Sewer 0 Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name La X-C, 1 1.�%'
Name:
Address: "loyAps go V e, l"1 r-
Company: �� (r ` C_
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City: `���:�` � <-�.°e�' �G State: R
Zip Coder Fax:
Phone No. 2W - /j99 - 00
Address-- �i� l� b 'e
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City: p_f (luu e tate: i
Zip Coder Fax: 561 `-lt�3 -1ty6
Phone No. -77,Q-_7'7?- COD
E-Mail:evPoevnNcgP h oo. Lo kvi
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License:y�
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.