HomeMy WebLinkAboutUntitled 4,. j.' 1
r
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED •r,„� 019(7Date: S'/3 O// g Permit Number:
( )5
. O ..I.NT)t .''.
E L O FG L. V Lk
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR:
PROPOSED INPROV
EME NT LQCATIC+N .., . .. ...
Address: tog I le it/eviQ.v 1il', e'. 'Ple t c QJI lL 3 4 el 1
Legal Description: (Torn li.vt SrIrr3 yt..cor 01 / 6 1
Property Tax ID#: 31401- 705 -(360 6— aOc:/e Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED.DESCRIPTION:OF WORK, ` ' ..
r v c' rjAl 10o&er 'o(e
CONSTRUCTION INFORMATION 3 ,
Additional .r.
work to be pertormed under this permit-check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: �9 Sq. Ft.of First Floor:
/Cost of Construction: $ /o' iU Utilities: _Sewer _Septic Building Height:
(31NN,ER/LESSEE CONTRACTOR: . ' .,,
Name r)O�d�Q.�l� Name: �� ii.
Address: (,4 (cr 9-vt/eYiw,61 pr• Company;
City: F-r-, p(e rc.e., State:Ft— Address: ......
Zip Code: 3t.16)ra Fax: City: State:
Phone No. 27.1.- 2.A 1/-g1?,zC Zip Code: Fax:
E-Mail: t7owuca,19e,le a koo.coWN- Phone No
Fill in fee simple Title Holderon next page(if different E-Mail
from the Owner listed above) State or County License
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.