HomeMy WebLinkAboutLUCIEN PERMITALL APPLICJIE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: II
Permit Number:
Planning anc Development Services Building Permit Application
Building and ode Regulation Division
2300 Virginic Avenue, Fort Pierce FL 34982
Phone: (77; 462-1553 Fax: (772) 462-1578 COmmercial
PERMITA : Residential
PLICATION FOR
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Address: 0 C -coo I�(zV -
Legal Descrip on: e 4 yt I ��c�
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Property Tax a: X1522 - 50 3 - 0133
Site Plan Narr L No,_
Project Name—A67 Cool (�
Block No.
Setbacks F nt Back: iJ
Right Side: Left Side:
IF 151
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itlona wc to a er orme un er t Is pen? I.
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I_1HVAC Gas Tank app y
j� ❑Gas Piping _ Shutters
L JElectric E]Windows/D'ors
0 Plumbing �Spl;nklers n
Total Sq, Ft of onstruction: �-7 Generator Roof
Cost of Constr ction: $ 3500,0 Sc[ Ft. of First Floor:
Y. 1 [[$([g,,
l Utilities: Sewer Septic Building Heigh
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Name
Address: Name: p-/Y�^ o
be
City: R Company: r8 wt AddPrGt
State: _ SP./vI
Zip Code: �� ress: �8 ((
Phone No. b olx 61D, City: J� (~ r;�
(o�� Zip Code: 349,Sa -1'V tater
E -Mall: Fax: b -)!
Phone No.
Fill in fee situp Title Holder on next page (if difE,arent E-MaII:Yv1 b wr�Z t ;
from the Own r listed above) Q(C�
q State or County License: CSC 0 S(�
If value of const uction Is $2500 or more,
a\RECORDEU, Notice of Commencement Is required.
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Name:
Address: I
City; ` l
Zip' Ph -n®. ^-
rte a"w77Ifn,E HOLpER: Not
Name:
Address:
Cfty:
Zip: Phnno•
MORTGNE COMPANY:
Address':
City: _
ZIP: Phone:
de BONDING COMPANY:
Name:
Address'
City:
ZIP:
Phone;
I certify that n�k or installation has commenced priorto the Issuansa of a permBt,
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am 'fie Florida Widins Coda and St W fe C wK k1 a3 re4P ants,
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WARNINGT OWNER:ynurfailurriu
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of Cos rlisult In Your paying twke G
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