HomeMy WebLinkAboutUntitled ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 0_
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Date: �1_L6-( 7 Permit Number: I "'�� 1/
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Building Permit Application
Planning and Development ServicesA1'� ' i. %®
Building and Code Regulation Division •°,44)
2300 Virginia Avenue,Fort Pierce FL 34982 410.42
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: 1,2, L-,;Pit c.r loom C(' -t ? IJ
Legal Description: p rlowr R..4'1,3.t F ic .i- 5 - b,..,..4 ef</ kii I laiq e_ 04'1'1' IL
Property Tax ID#: f c .-{ LS -bof- oo i t-/- 000 Z Lot No.
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Site Plan Name: fitLAri a J \ ..e...5 i c e-n,_,_ Block No.
Project Name: 9rzV 'c s je-A.c-.e._
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
1 - c e_ ('9'La.c.z_ fro✓ --- e..M-r7, atoo✓/ _4/2..._,_ Fr 5iZe_ ,
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CONSTRUCTION INFORMATION:
Additional work to be performed under this permit-check all apply:
HVAC I _I Gas Tank ❑Gas Piping Shutters I Windows/Doors
ElElectric Plumbing SprinklersIll Generator [II Roof Roof pitch
Total Sq. Ft of Construction: Sc, Ft.of First Floor:
Cost of Construction:$ Z_7 0 0 , Utilities: Sewer El Septic Building Height: _
OWNER/LESSEE: nn p '. CONTRACTOR:
Nameeto �,, *L;AAggt... Pre-V:6U Name: _vr`-I-i (✓ :‘
Address: 13 -L.'3 SMi) 0Mi) V-413 e. 11 V4 Company:(,J) R_ ?,,..):11 lets 1c '
City: (140%.l n , 6.€' j State: FL- Address: 3 2.-31 5 C 6oti►i n'c-� Te_.l
Zip Code: .Lel1 O Fax: 4 City: S 4-4./0:.(-4-- State: FL
Phone No. Loa ZO2 C,SZS'3 Zip Code: 3'1 9 I Fax:
E-Mail: Phone No.11 Z 1'1$( Z-5-°5
Fill in fee simple Title Holder on next page(if different E-Mail: C....)1/4i b 0 ilA ef> . Lcviv‘ ,./
from the Owner listed above) State or County License: (5LL. Z 3 S'6 3
C.6-C- 1 So 4717 y 9
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.