HomeMy WebLinkAboutPugliese Permit App AC pg 1 001LLL APPLICABLF IN O gMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: O Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division O
2300 Virginia Avenue, Fort Pierce FL 34982 'V/o
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 IMPROVEMENT LOCATION: -' L r
Address: �&pi0A � [ 1 Cc. �k a �J
Legal Description: _k i(LWIA� _ p(,A M-- IQ Rj ie—'- I �)M A [i
Property Tax ID #:
Site Plan Name:
Project Name: _
Setbacks Front
Back: Right Side: _ Left Side:
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK: i
Gru ICU,'-Ms-vai i new Nheern 14 _SE_ac 3 10 au
CONSION INFORMATION:
G
1=JHVAC "Gas Tank "Gas Piping
11 Electric 1:1Plumbing nSprinl
Total Sq. Ft of Construction:
Cost of Construction: $ '8400.00
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5�F'tj. of First Floor: _
Utilities:L 1SewerElSeptic
Windows/Doors
Roof
Building Height:
OWNER/LESSEE:.-
CONTRACTOR:
Name 11
Address: 1�Q 1(
ff
Name:
Company: \ (Q rcr(lyt
City: �Q� IAU State: t,
Zip Code: ,,J ,51-- Fax:
Phone No. �4
Address/
City: �I �VjQILQi State:
Zip Code:�46( X1;1-I�(r(�-373
Phoneryo.� 1 4-1
E -Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E -Mail: b(YJ
State or County License:
V, Lummencemenx 1s requirea.