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ALL APP C l E INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCFPTED
Date: Permit Number.
- - I
I RE IV ED
Building Permit Application
Planning an Development Services ` Ni C 7 2018
Building and ode Regulation Division rmitting
2300 Virginl Avenue, Fort Pierce FL 34982 j ST. t_ucie Co nty,
Phone: (77 462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT A PLICATION FOR: To Select;from dropbox, click arrow at the end of line
Address: 113,'�00 -Zt�- -2,0
Legal Descrip on: 14`av,4-)75 4 1 "I�j
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Property Tax #t: LAStoo)N r tion--� L It No.
Site Plan Na BI ck No.
Project Name.
Setbacks F nt Back: Right Side: Left Side:
itis a Iw o nr ormcd un er t Is pe ni —c ecc a app y:
HVAC Gas Tank Gat; Piping Shutters Windows/Q` ors
Electric Plumbing Sprinklers Generator Roof
Total Sq. Ft of onstruction: S .Ft. of First Floor:
Cost of Constr ction:$ a ' Utilities: Sewer ElSeptic Building Heig
.01
Name Name-,
Address; Company: ll� tcvvy
City: '-r ei►^ e.CAa-. Stare: FL Address: 69(I
Zip Code; Fax: City: !2°Y, Sa' lIJ« tate:
Phone No. Zlpcode: 3q6?5�)- Fax:
E-Mail• Phone No. 't'1?,
[rill In fee slmp a Title Holder on next page(if dfl erent E-Mail: rn l-,-r �' �
om the Own r listed above) State qr County license: �lACO�b value of const uctlon Is$2500 or mora,a REcoRDEt!Notice of Commencement is required.
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