HomeMy WebLinkAbout002ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: o Permit Number:
-J: _J I J 1'_"JW.
s
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: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:'
Address: 1 _�) \
Legal Descriti l�(t
F5 Ni R
Property Tax ID #: 3L
Site Plan Name:
Project Name:
Setbacks Front
yC�l(� �1Cr1
iIS` C)- (DI(o� - O Y�-
Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Lot No. CQ 15
Block No. W7
O\C 004- - \N -P- \%lc -2
��kleCe e_XiS-h'nnj ). S ton. I Ll Seer , -7.5 K\,\) iii 1 t'�eC J
'�)'S +\�)(-,, 114 Seep , .S\�w
CONSTRUCTION INFORMATION: I
ACICutional worK toe performed i
under Tspermit-check a tataaav:
HVAC 1:1 Gas Tank :Gas Piping
11 Electric 0 Plumbing Sprinklers
Total Sq. Ft of Construction:
<, n
Cost of Construction: $ q, (a -c-) ,
LJ Shutters E Windows/Doors
EGenerator E] Roof : Roof pitch
S Ft. of First Floor: _
Utilities: Sewer D Septic
OWNER/LESSEE:
Name�ll-�bt�
Address: 5 2I & N W A I 1 V e
City:,?SL State: f__�
Zip Code: !aHgg(L) Fax:
Phone No. ?'?,P - q 0-
E-Mail:()r r2Y(1(25(1CN e'cf)ry )
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Building Height:
Name:
Company: TT&A
Address: L4s(o a..0 '0-)600YS(i e ej
City: rr L State:
Zip Code: 3Ci-1n 8 i Fax:
Phone NO.Suk- Qq Ci - Li LDI D
E-Mail:+I7l)e_- eMjJLLC % rC , ( OCiM
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.