HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number.
Building Permit Applic !on:
Planning and Development-Sevices
Building and Code Regulc*an Division
2300 Virginin Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-3578 Commercial il Rdsidenflal
PERMIT APPLICATION FOR: To Select from dropboX, Clickalroy"V C the end of line
OROPOSWIMPROVEMENT-LOCATION;
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Address:
Legal Description:
Pro pertyTaxlD#.- LI-5,0 S-0 1 -1
n - G O'ci Lot-No.
Site Plan Name: Block No.
Project Name:
Setb" FrontBack Right Side: LeftSide:
DETAILED DESCRIPTIOM-PF-WORK-,
7 7
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:CONSTRUUIOWNFORMATION: ::
A(Witional Work to be narl'ormed -un er this permit—c a all app hr-
las Pipir Shutters!
EIHVAC CGasTank F OWindows/boors
P
Electric Plumbing E]Sprinklers ,Generator 'of
Total Sq.Ft of Construction: Sq.It of First Flo' or.' 1�
Cost of Construction:$ Utilities:
Sewer Septic� Building Height
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OWW/lESS-EE:'
Name 17, '4 Name. John R Law
Address: 1 I jj !V --EfL,Jg 1,, Company: Lateks F-JectKicial Service Im
Cit)r State- Address: 51581 NW Pdinm St 11
ZiP6de: LI 2-D Fax- C4: PT ST LuGq 1, FL
Pho.n el No,1- r-U 2-(,-, Zip Code- 3496.3 Fax:
E-Mail: PhoneNo_ 772',3704357
Fill In fee simple-nde Holder an next page(if different E-mail:johnla,0158601.com`
from the Owner listed above} State or County Licens:ei- 29432
If value of construction is US08 Or More,a RECORDED Notice of'Cl—ommencenlent is required-
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