HomeMy WebLinkAboutRevisions AII'APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:_ i Permit Number: Rak -On��,
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_ Building Perm Y r
Planning and Development Services
Buildingand Code Regulation Division 1�
9
2300 Virginia Avenue,Fort Pierce FL 34982 /
Phone:(772)462-1553 Fax.-(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: �,��lG� Q
N OSED IN OVE E� LOCA ION:
Add//��ress: r�,��� ltd Qc� Y��S 0�.�� +'X 0
Lemma cr"ip`fio310'�'
Property Tax ID#: 23/2-- ,r1 14 c1 D d 2 -- o eo- Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks, Front Back:. Right Side: Left Side:
! SLED DEn R1 1,01 111011
W ` �� 3 cia4e,6 Lf fAcIrlrhi9�i
C ST UCT • C FO' . T10N:
ttiona w.or to a pe orme under 1is permit-check all that appy:
_Mechanical __,.Ga.s Tank r Gas Piping _Shutters Windows/Doors
Electric` ^Plumbing -___,Sprinklers _Generator Roof Pitch
Total Sq.Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$��� _ Utilities: _Sewer. —Septic Building Height:
0 , ER/L USES@ : CONT
Name Arp I(.IG- J 1.ti c,61- Name:
Address: �'4a 4 3"en�� r►4
. 5�:. �d Company:
City: yvptCtce State:l'I Address:
Zip Code:?,4q4:1 Fax: City: State.
Phone No. =zZ1 .:,7o- - 0-362- Zip Code: Fax:
E-Mail.- RTL B A L I /l ,44. 6014 Phone No
Fill in fee simple Title Holder on 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.