HomeMy WebLinkAboutUntitled ALL APPLICiWLE I MUST BE-COMPLETED FOR APPLICATION TO BE ACCEPTED )) ,„� �. , /�/J�
Date: Li' Permit Number: _ jV(U 4
COUNTY fQFc i
Building Permit Application Ivo - 4°
Planning and Development Services p i ttt/,�9 41718Building and Code Regulation Division �4ci 0
641
2300 Virginia Avenue,Fort Pierce FL 34982 e Co n eot
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 IMPROVEM'ENTLOCATION , `"i ..
Address: 2 %S b 4-61,2. 0►sIf-td 4 v 4-6- ‘v,Led t P '3(4 q top
Legal Description: NV f C C.111 . No e 60V
Property Tax ID#: ( 428"-- 1 OZ - 1 3 4I. —0 Oct--1 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTIO"N-:O-F WORK: _
To VA 61--A-ti, 02 • 5- ``Q 1.1 I,4,• s- 6 ee a. St a ett 4 t t 1 ih i2. Cm/1)-
CONSTRUCTION INFORMATION r,
Additional work to be ertormed under this permit-check all pail apply:
1:1HVAC Gas Tank Gas Piping Shutters Q Windows/Doors
Electric 1=1 Plumbing (Sprinklers Generator ❑Roof Roof pitch
Total Sq.Ft of Construction: Sc.Ft.of First Floor:
Cost of Construction:$ -- 3 66 0 Utilities: Sewer El Septic Building Height:
OWNER/LESSEEz ._,. CONTRACTOR L. _ , ---z._-'=-:..
Name $ K1 f JSP Name: F �% `eZ. V • _�vNl7
Address: t440 (.-0. ( g l 44 es I• Company: PAL Z.z Z GCL ► N7. 3 A-:4.)
City:Co H C l S�ti t.w� State: cf Address: el'No a STSc.-1--- d"c
Zip Code: 3 01 t Fax: e City: U CZ.° { i State: Eel
Phone No.('3 mS JEd.n m t SO .Q-a.c Zip Code: v31- %'l Fax:e n 2-} SSS 1 - I!t(
1
E-Mail: Phone Noh 1 o`�) nn53 W - ' $`d<
Fill in fee simple Title Holder on next page(if different E-Mail: V-R-,i'ez `? NO ) F4.11--a. W2a t t N
from the Owner listed above) State or County License:(. cid( Q .Cor(
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.