HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10 117 1 (-7 7Permit Number:
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: 39990 Address: (POO Q' () V TS Lf �(YJ atm L -I- r c . f I-- 39 (qG/�IU
Legal Description:
Property Tax ID #:'A9 ":61 0- 0(X)b_ 000' D Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
2xCI,an� o� eix.:4,' 3.S �oh jQ)k,,1
CONSTRUCTION INFORMATION:
Additional work to o >I e eeorme under this permit — c ----hecka apply:
HVAC 11 Gas Tank Gas Piping _ Shutters Windows/Doors
11 Electric El Plumbing ❑ Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $
S Ft. of First Floor: _
Utilities:Sewer Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Oder of
Name: A[
,
j, p
Address: (002)��, � / L w_k ^ltc
Company: :f c
S
City: ?e II L+1 State: F L
Address:: Li'S 51
Zip Code:Fax:
City: LPG
State:
Phone No. 7 l? a S36 '�6 l-7 5
Zip Code: .39979 Fax:
E -Mail:
Phone No.
Fill in fee simple Title Holder on next page ( if different
11��3���
E -Mail: a C Gr1cJl eCJ\
a ft -CM'1
from the Owner listed above)
State or County License:
AC
CAC V I D3y�
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.