HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /�
Date: 21?-2 / �S Permit Number: Y_(� U"L S7
Building Permit Application
MAR." 1 2010
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:
PROPOSED INPROvHMENT" LOCATIt+aN:
Address: 4&14 vK c!�91o 4 S
Legal Description:
Property Tax ID#:yk,') 2 76 2 ''3FO GSD r 7 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks. " Front Back: Right Side: Left Side:
DETAILEDDE�S�R+IPTIQN ®FW�R+K:.r ,, ,, .
CC�7NSTRUCTIO INFORrMATION:
Additional work to be pertorme un er t is permit-check a t at-app y,:
Mechanical _Gas Tank _Gas Piping = Shiutters _Windows/Doors
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$��� Utilities: —Sewer _Septic Building Height:
OW NER f LE=-SEE: CONTRA OR
Name &tA14 IY14/,' Name:
Address: �b W. OLPa' Company: L
City: r' c''-' peaeA State:EL Address: U 7l�
Zip Code: 15 7 . Fax: City: ?�Z/ , Pi/P(Cf State:��
Phone No. ! 2 po�� Zip Code: ?7� Fax:
E-Mail: Phone No Z72"1 N- 2 7 ?r/
Fill in fee simple Title Holder on next page(if different E-Mail 16CL a r2lec 4,1 wcu
from the Owner listed above) State or County License L/nC /2 S o_3 70
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.