HomeMy WebLinkAboutROWE 1ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
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
PER APPLICATION FOR: To Select from dropbox, click arrow at the end of line
P'RgpOSED IMPROVEMENT LOCATION:
Address: I
Legal !Description:
Property Tax ID #: `f _ j - t C' i Co — CKM — Q Lot No.
Site Plan Name: Block No
Projeert Name: _
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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CON TRUCTION INFORMATION:
ona wor to 5a er orme un er t is pdrmit — c ec a appy:
;HVAC Gas Tank Gas Piping InShutters
PElectr
Plumbing Sprinklers CGenerator
Total Sq. Ft of Construction: S. Ft. of First Floor: _
Cost of Construction: $= Utilities:T]Sewer OSeptic
OWNER/LESSEE:
Name&rw%, 4,--1&v,F-.:;_.,{ Y nam
- ,Vl( C T
City: f = - Y— • e cce State:
Zip Code: 3qY,9* Fax:.
Phone! No.
-7/ L/
E -Mai):
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
0-- V%jL to I -L -40+y n_-
Windows/Doors
Roof O Roof pitch
Building Height:
Name. lol
Company: L4J—C,
Address: '-3—>
City: r — - a :: L State: JQG
Zip Code: .3 ` Fax: t-1 & V—
Phone No.5-..1 S` %6-
E -Mail:
E -Mail: ('41 � �', � Co.,
State or County License: C G ) l
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.