HomeMy WebLinkAboutmobil 1ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34382
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: � 9,5 c�.-,?.';—
Legal Description:
Property Tax ID #: (.tian - o " }` t Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
ACIC11tional work toa er orme under this permit - c ec a appy:
'HVAC 11 Gas Tank DGas Piping _ Shutters Windows/Doors
11 Electric E Plumbing Sprinklers E] Generator Roof Roof pitch
Total Sq. Ft of Construction:
Cost of construction: $ 9-LacoC~11
Scl. Ft. of First Floor: _
Utilities: Sewer Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name /n e, ,+ e%.-
Name:
&J :,-'.-7
Address: 0- `a
Company: W e
f` d ,,I
_
City:" _ `- e c c t State: j;L
Address: S'
e u vrt�
Zip code: '3 9 0--r Fax:
City: n • L C'i
State:J!f<.
Phone No. ''i -7 - LIS -7 • t 0
Zip Code Ll9 �'� Fax: L(to Ll — I I .�
E -Mail:
Phone No. 4 L{.
Fill in fee simple Title Holder on next page ( if different
E -Mail: 0 C3_;" (-C,"i
A :, w, I &e 14, 44,
from the Owner listed above)
State or County License:
AJ -361
�i va um ul cugumfucoun us ,pcwu or more, a KkG9K0EV Notice of commencement is required.