HomeMy WebLinkAboutBuilding Permit Application ALL LEI O MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 19i^_ 0 ,5
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Date: f ' Permit Number: !
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COUNTY
F L O R I D A-- -
REC�/E®
Building Permit Application
Planning and Development Services MAY 14 1018
Building and Code Regulation Division ►'e►mittin
2300 Virginia Avenue,Fort Pierce FL 34982f 6HQe epae t /
Phone:(772)462-1553 Fax: (772)462-1578 Commercial i essldtiai V/
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:_
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Address: o. gZ o kike c to J w 14� t.� ' C( 4, q (to
Legal Description: Nv A-C C.itl ia kJd e. ()Ur
Property Tax ID#: ( `i-A ' 102-" 1 3L4 --Obb t'`
Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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CONSTRUCTION INFORMATION:
Additional work to be erformed under this permit-check all- apply:
❑HVAC [1 Gas Tank Gas Piping Shutters Windows
❑ p g — El Windows/
Doors
Electric D Plumbing Sprinklers E Generator ❑Roof Roof pitch
Total Sq. Ft of Construction: .S94 of First Floor:
Cost of Construction:$ 9 I nd , CO Utilities:I _Sewer ElSeptic Building Height:
OWNER/LESSEE: CONTRACTOR: nn
Name 9 , iz�3 . Name: F A 1 Z Cr• 0 .k k.rN l7
Address: ICON ,o Q. A( y' Lad 2, ii f • Company: FJ i`r z ecl t N 3 f(-z�i,
City:C9 2-4A Cw
sitiT State: q Address: 6a.ado q s-TIA- c4.- II((
Zip Code: 3 b t Fax: City: 'J02..,12.0'02..,12.0JA State: 1
Phone No. '3 lVS 6.21- m(. (21.0 Zip Code: 31- CIO l Fax(119-1 5 I _I a t .ri
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E-Mail: Phone NoI'1l a, 5-3 %. - 4-E a..$9_
Fill in fee simple Title Holder on next page(if different E-Mail: a-it2aIR too 02, F.ti- e. W2aTt.'
from the Owner listed above) State or County Licenser 1 am i44 .cowl
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.