HomeMy WebLinkAboutBuilding Permit Application (3) All APPLICBLE INFOMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: q , to. (.Od Permit Number: 1 V 1 - 61 (o 0
FLORIO P 0
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_ Building Permit ApplicatI n �9 oe
Planning and Development Services S�-7ng Z918
Building and Code Regulation Division we/ e4arto
2300 Virginia Avenue,Fort Pierce FL 34982 oto 'ent
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential ,t
PERMIT APPLICATION FOR:
PROPOSED UN•PROVEM LOCATION e=
Address: 1 F 1 i col v nom. A UJ j r St vUk F1 -- 3 [ 3
Legal Description:
Property Tax lD#: 3Lt (9‘" 5- 30- 0Z ' - )CO (C — Lot No.
Site Plan Name: Block No. L4 0
Project Name: f v.- SQA tri -1 1o,.�,c yc -,
Setbacks Front Back: S Right Side: 2- Left Side:
DETAI(U DESCRIPTION CIF WORK° .
S1n,LA t s '6 X 1 QQA- pvcs``(t�� c_4w,C ' 'r-1(10- - 5
b-,\t b JiLltv&'y r° b�sR.. , 5- tt- - from tte Lv
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CONSTRUCTION INFORMATIONo
Additional work to be performed under this permit–check all that apply:
_Mechanical _Gas Tank _Gas Piping' Shutters _Windows/Doors
_Electric _Plumbing _Sprinklers —Generator _Roof Pitch
Total Sq. Ft of Construction: ` / 00^ Sq. Ft. of First Floor:•
Cost of Construction:$ 15-00 Utilities: _Sewer _Septic Building Height:
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OWNER/LE S 12 „ :CON RACTOR° a ., .
Name Too\r''' r t4V( ' - Name:
Address: Ig1 NIpv-or\_9, A✓C _ Company:
City: row#- SA' LGLI State: L- Address:
Zip Code: 3` t ct 3 Fax: City: State:
Phone No. 30S 6 oq_ 1"59 Zip Code: Fax:
E-Mail:_ cmv_ .1, ,. co.,-7 Phone No
Fill in fee simple Title Holder on next page(if different E-Mail
from the Owner listed above) State or County License
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.