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HomeMy WebLinkAboutBuilding Permit Application I 1 FF'AAIC LE tiVFp MUST SE COMPLETED I' APpLICAi 1QN TO BE ACCEPTED Permit Number: • I BWdi:ilig•Permit Application Planning an' Development.Services euildln49 and ode Regulation Clivlslon I 2300 VIrginf Avenue,Fort Pierce FL 349$2 Phone: (771 -1553 Fax;(772)462.1578 !I Commercial Residential 4ddr'ess- PERMTA PLICATION FOR: '1To 8elec�from dropbox, click arrow et the end of line go Legal Description: 'gr 4 h MA vj4L A i Property Tax #: :pLoo— Site Plan Na Lc t No, ProjectNam.e. ���j�,v��j�c, ,� ` gl lick No. ` Setbacks F nt Back:- � -Right Side: Left Side: f f � i I na w to a orm� un er sperms �o ec �=� Y�;ts'iti21;y a apP Y: HVAC Gas Tank Gas Piping Shutters Wlndo s/D ors Electric l Plumbing Sprinklers Generator Roof Total Sq.Ft of onstruction: 5 .Ft,of First Floor: Ciost of Canstr ction:$ �l-� + Utilities: Sewer Septic suildin !et. t; i g b I ' Name t'• w�t c+r.�-,a.,/ a s:.s Name: Address' b 1 IL►U ,}��.�. soy I Company: 4�rtr.aoy�c� vim. I ty: State Address: 6f 13 Zip Code: ��`�_ _ Fax ' City' a . Sa I,.,[%�e tati�: j Phone No. �� '-f 'y Zip Code: �`��1 Fax: ylr' 3l E-Mail: + Phone No. 46]- V3)3 Fill in fejsimp tle Holder on next page(if dif erent E-Mail: M m� �ar�-rova-�c4b from thted above) State or County License; '' 0 5 fo I,-4 LI If value of const action Is$2500 or mare,a RECORDED.Notice of Commencement Is reg4tred. � i i z• H E tit " pig ' 'i'QJCMIriIP : „fat A�pplf h�an�e: �� I Address• AiddrosS> i QtV:. sta+te::,,_„•„ hip'. Photaaa.. Pf�brt;e: �.� ZIP- EE sIN m �ial�Eits ...,.Flo#�4 IpEl fe �Qtllt �t�R JNIP�Etif'If: , �lt�t A,pp l Zf�ert��- Name. . Foss: city" Zip= ." IIB• dip:, „�.- • - I awtgy thim oc WorkorJmWlatimhal noat�n;en�l ` ptigr�tol�Esvuan���p�,ml�. 4 I 'I St.l R M' qa ...1 tha li R!£�i erng1Q �yµ�9 tlalE�$srGr�1k tobuy, rdC$ ure una"� i l� � ''"' MW4iA 912 1 1 ' n� 6 SCF ' ' tli a qty. #9i h Inedniiddtrtia1''thegmndnt$0fthifsr lnd l�,l�i�airOith�6 ,Fili®:t�pla:�,.l9avinRrgr.tCnew�ck I i in•aaeerdanea• tlMaep�e�r�a�ai►s,,.the.Plg�lidttgt�drsa�tl•�taG',tAs�a�iakgr+�ir�dq�iRcs, Tha Wwwr4b 16 j ltM1C�IQ COlfG115�h�19;fi110 It�fD�TSdAAI��f$B14Si�Ql{ i ir�Dfl lrfi �L�Y�{tK+�lrZ4ib113 Bd511tISl r JI aaozs�p�rs�itC •r�.s�ltYl;rdln�Pvaf�,.•testa9t wat�,�?��C!'dir�mlvl'iteanttaty.uststn.�ltticstltae n�daid�n4lal uslt WAl�+tlWO - CMNERt Worfali mm-to afturo A.kKilmof cct�tm�ttwetn�k # ffitsg tw+>Xe fa y irlo vans 'ra ter �ptrf .A I at ��'com.wee �#�t�Ek be I� � f Es tm1$ IflS(r Lb9J�� mnd ppskd�Di1 thajobs it ta.100n fin, . 6clit dt 1 ]'ei war©�r aft•atfor�mey bd6re yore "oncln Oftfl' �1 t '. I iTA� it RIi�A� T l ::0 D I cou a � The fal�w�Sl,a ns l u w&nt VIa a aftum d f efftrm m � 1 f110 f rad 11n4tt tit ac�iriawlad�,bd•beflgr�me this„date ,.. h i8"br 3 ISIS [PR9srf�+OF flertl �tiupour� n�� �f��eaf�rr�t�11' �dlt9ittt I I �Sl9nilltureaf �grwPub y t��• iSiprl�iWtaafOfr�.F t�#t�lninitlal� ` Parsat�my ^{ttcR [ifand pblria _ PerartaltlrRfAaud�n�,, ^��IR"•P�nlc cesd6dmn�tif4ee ian I �leof ident4�i lnn. l'�'pla+sFadrlrtti than Pnodu . 66 Ae tmmplyAno Nrt;4'? �.--- >l�lO�ni�i�dt�r�arEoS�t#�M"A Y�1 51r" ZOI"1 stir, P!�5 WraffATIOR SFATURTLE tVtAaVE IIREVIEW RRVr1REVIEW I I`1 i i - I • f • f