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Building Permit Application
ALL APPLICABLE.INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 0M Date: Permit Number: � "`" L 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 I/ PERMIT APPLICATION FOR: PROPOSED IMPROVEMENT LOCATION •• F Address: 13o 11 S T WQ i M R 1 4 L�l Q f_ .,.a U1 V-M T))'AC-HT�� 3 7_ Legal Description: A 0�-1 a0 - Ono,)- "(O ontl ct-_J 7 q l Property Tax ID#: 4 Sd l - 1 AQ '6O 2 -ooC) / 7 Lot No._� Site Plan Name': Block No. -3? Project Name: i Setbacks Front Back: Right Side: Left Side: DETAILED'DESCRIPTIO,N OF WORK RPV') AC-1 kY_ - 'FY'D Lu �o l2/ bar 1 h��oor'� W N oce-�S, 1 C()c 1�e SL\ D�V- To OdOL_ CONSTRUCTION INFORMATION r. itiona work to be performed un er t is permit-c ec all that appy: _HVAC _Gas Tank —Gas Piping _Shutters ✓ Windows/Doors _Electric _Plumbing _Sprinklers _Generator _Roof Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction:$ Z5 060 Utilities: —Sewer _Septic B ilding Height: OWNER/LESSEE " n" CONTRA 0 •x . Name DAwo h'0)IZRO 7 Name: 12 Address SILL)Q I(A IU 121 Ut V )OV Com a y: City: State: ( L Ad ss 4,.F 6'1-- Zip Code: 3 q q 571 Fax: City: '�Ox7- State: f Phone No. q -may -Q r; S_/ Zip Code: zazf Fax: E-Mail: '0-t/l,_ 0 G-J 12� 8 TT,, q�= Phone No. JZ2- 8'-77-©L !o 4 Fill in fee simple Title Holder on next page(if different E-Mail: _911Ke 7oz;,bA from the Owner listed above) State or County License:C13 e- /zs��3s��z.. If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.