HomeMy WebLinkAboutBuilding Permit Application l$
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ALL APPLIC LE INFO UST BE COMPLETED F!(,*,R APPLICATION TO BE ACCEPTED �
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Date: 5 a. Permit Number: �`�'�
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Building Permit Application h,+a 2 9 118
Planning ani Development Services
Building and ode Regulation Division S-1. Lucie unty, erml
2300 Virgini Avenue,Fort Pierce FL 34982
Phone: (77 462-1553 Fax: (772)+462-1578 Commercial � Residential I'
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PERMIT A PLICATION FOR: To Selectfrom dropbox, click arrow at the end of line _�d
Address: 1 asb NtA
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Legal Descrip on: QCfaY+ �"iw c,,r 5 u,� �
Property Tax #: L?L'-As " Sod C)05 : � (�CJO�"� L No,
Site Plan Na 4-91a"'(-k BI ck No. i
Project Name i
Setbacks F', Back:Back: IRlght Side: Left Side:
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I lona v 0 e er or ed under this per:mi -c ec a app y:
HVAC Gas Tank ❑Gas Piping Shutters Q Windows/D ors i
Electric" Plumbing Sprinklers Generator El Roof II
Total Sq. Ft of onstrurtion: S . Ft.of First Floor:
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Cost of Constr ction:$ may)+ Utillties: Sewer Septic Building Heig
Name �6,-& . Name: 3e_;,re
Address: ��� N. 1-'w 1i��><s - iy '. Company: ti1`k-
City: e,W(a_ Sta(e:�- Address:
Tip Code: (4-01`-f°I Fax: City: Pads S�- t+�i tater`~
Phone No. "ISS ' �f1a A sh Zip Code: 2,'A Fa x:
E-Mail: Phone No, �'►'12 r' a'1��313
Fill in fee simp ie Title Holder on next page (if di,.Brent E-Mail: rY� 'or� br fit ' c°v�-•
from the Ow4r listed above) State or County license:
Cf-c- 0 S i Sb.}
If value of const uction is$2500 or more,a RECORDEGy Notice of Commencement is required.
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