HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED _
Date: O q/ZN/ZdlB Permit Number:
tr46 'v Z7
"Yrs
NY
Building Permit Application per 20s
Pianning and Development Services and Code Regulation Division t/hDe
uge Canty
Buildingnt
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 SED Il [PR011EMENT LOCATION :, �b .. ' ., ._ , wu ` -
Address: 55111 I/ ;//grnc/ Aw.
Legal Description: La he c,J006, Paso's - OA;-V t - Q LIG, 13 7 LCAT 31
C t-4/1-P 13 I 12-10 )( O r 1\$6 - t 3i7
Property Tax ID#: 13,01- 6) 3 - c)631 -o00 -6- Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:: � s
- 'a°a'�, . �.�. `�✓fir,t,'� � w `�?.� �:_ ',ea..
Tear oFF , rooF clown 4o dcc&., replace ro-feel ply wasoci as Ateede.d,
ec.-110:, 1 cSac.. -4-0 code, app11 selr-- ac)herccl oraCr (A�frnend' i,s'a1( 5kr, IC,S
-I'o cocic, ;r1 ,51-0//,1 Vev-fs as need cC
FL I$35s RLI Critcs) FL 16648 /Z6 ( CAC * )
CONSTRUCTION INFORMATION , ,
,; t
Additional work to be performed under this permit-check all apply:
El HVAC _Gas Tank nGas Piping Shutters I l Windows/Doors
ElElectric ❑ Plumbing Sprinklers El Generator [ZiRoof 5 2 Roof pitch
Total Sq. Ft of Construction: Z/`/Z S•. Ft.of First Floor: 1755()
Cost of Construction:$ /6, 0 7T Utilities: 1-Sewer 0 Septic Building Height:
OWNER/LESSEE CONTRACTOR:, s:
Name f AAc. c �1,.; LG(win S Name: &,Chc„n'1 Co 1k+ ,
Address: V `5G4c %&PoQLl,ne Av C Company: LeAlc. iiJderS /e0oF fecpQ;r
City: cC14 Pjcja.. State: It Address: (;/0/ bvl,/1 a✓t an 0r
Zip Code: r9��1 Fax: City: FUrd Pic.(cc. State: I- -Phone No. 7 7 Z) 877 - O t 0 5 Zip Code: - 1-4 q $Z Fax:
E-Mail: / Phone No. ( 7 7 Z) 331 - 81/6-O
Fill in fee simple Title Holder on next page(if different E-Mail: C;Ch:ecc.1)e-t-4 Di ma;l •C6/Y1
from the Owner listed above) State or County License: (U, 13 30'3'7 '
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.