HomeMy WebLinkAboutImage (7)ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I r� )) ! Permit 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: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description: V U U 'J U 1-1" 1-1 e, I'" t J it r \/b L/0 l) I I L, 01-3
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Property Tax ID #: ; Z' "�' - 0OSK� C)c 0 - re
Site Plan Name: &Xlt_ft r T! e-) ct ` V I C tc I C
Project Name: r h t'1 CA
Setbacks Front Back: Right Side: Left Side:
Lot No. /-I I
Block No..
HVAC Li Gas Tank DGas Piping Il Shutters Q Windows/Doors
Electric ❑ Plumbing Sprinklers E]Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
C -i,;
Cost of Construction: $ ) `) . Utilities: Sewer Septic Building Height:
OWN ER/LESSEE:
CONTRACTOR:
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W/ I O u -Lo V-iif)—i-CC, i 5 <Se ( A -f --j .
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CONSTRUCTION
INFORMATION:
. co
Acid M96a I work to be
Performed under
this permit- check all
that apo v:
HVAC Li Gas Tank DGas Piping Il Shutters Q Windows/Doors
Electric ❑ Plumbing Sprinklers E]Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
C -i,;
Cost of Construction: $ ) `) . Utilities: Sewer Septic Building Height:
OWN ER/LESSEE:
CONTRACTOR:
NamellCA, I N i(_erC i� Ili "1f l fic_f f i C 6 (
Name:
Address: t -i L-"1 6L)OCI I LI 1 ("I
Company: ]Lr _ i S
City: o(- ( (- Pi n- d State:di
Zip Code: C6 t Fax:
Phone No. rN (? •� I (�'�
Address: C, `'') L
of- LU
City-",� a o —
Zip Code: ��L- )C� i—I
Phone No.1 -1 1
State:
Fax:
E -Mail: C
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail t
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State or C unty License: Crio
9- Q )l IX( a
it value of construction is 52500 or more, a RECORDED Notice of Commencement is required.