HomeMy WebLinkAboutsneed 1ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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R 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: 3,!579 i SS,r1,�
Legal Description:
Property Tax ID #: LA k ` ` - 00 35 000 `7 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: left Side:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
CONTRACTOR:
Name `r5 r
Additional work to be n orme under this permit- check
all appy:
Company: UJ C) r- Cy
HVAC
E!
Gas Tank
DGas
Piping
In
Shutters
a Windows/Doors
0 Electric 0 Plumbing
O
Sprinklers
CGenerator
Roof Roof pitch
Total Sq. Ft of Construction:
J ' � :wa 6e Is,— -
Sq. Ft. of First Floor:
State or County License:
Cost of Construction: i a -`�
Utilities:0 Sewer Oseptic
Building Height:
OWN ER/LESSEE:
CONTRACTOR:
Name `r5 r
Name: c9 c,r-l.. LJ
Address: -7.'2
Company: UJ C) r- Cy
City: �State: GL
Address: � (7
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Zip Code:3 L1 �f` ( Fax: -
City: r= � i0 e CE -L
State: G
Phone No."i a - '3:Z a `l '-[
Zip Code: 3`-1 5, ` r a_
Fax: 1-10 L/
E -Mail:
Phone No. '-" a _ 1-'(U L1
- X `I
Fill in fee simple Title Bolder on next page ( if different
E -Mail: W 0 r C-4 V1
J ' � :wa 6e Is,— -
from the Owner listed above)
State or County License:
L' 151 '25(a 6-Z
VOu= U cunaarucoun Fs mwtj or more, a KhtLUM't?MU Notice of commencement is required.