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HomeMy WebLinkAboutpaw 1ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED t Date: Permit Number: 4 - J Building Permit Application Planning and Development Services Building and Cade Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 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: , L v .' . t , .. Y� 00. Legal Description: Property Tax ID #: qC1— 1 v - a - 9 _ Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: I.eft Side DETAILED DESCRIPTION OF WORK: I is IV-L1-il INFORMATION: riu 1-1— wW1A LW Nc cl 11JI11lCu ulluCl NII] f7C11111L— VI HVAC Gas Tank ❑Gas Piping 11 Electric © Plumbing Sprinklers Total Sq. Ft of Construction: Cost of Construction: $ 7 apply: Shutters Windows/Doors Generator E]Roof Roof pitch S . Ft, of First Floor: _ Utilities:Sewer Eheptic Building Height: OWNER/LESSEE:` CONTRACTOR: Name` �� Name: Address: 0 7 Company: +4•r ir'wr�'• •� City: t -"N Stater Address:&" Zip Code: `-j,Ci ? ci Fak: City: _ cla e' Stater E4 - Phone No. Zip Code: �'f �TL Fax: -77 1,,2 7 E -Mail: Phone No. •77;? - t4 - u (- l S - Fill in`fee simple Title Holder on next page ( if different E -Mail: CJC .�- t- GU vt- l �:} e[ from ;the Owner listed above) State or County License; C t -1 `k\ 3(v k / a value or construction is:1AbUU or more, a RECORDED Notice 4f Commencement is required.