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ALL APPLICABLE INFO MUST, O P ED OR APPLICATION TO BE ACCEPTED r
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Date: '7 ` aj ermit Number: LJ O
0
RECEIVED i
-- -- — Building Permit Application FEB 0 4 201'9
Planning and Development Services ST. Lucie County,Permits
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: To Select from dropbox, click arrow at the end of line
PROPOSED 1M'PROVEIVIENT LOCATION:
Address: 9305 ; –A DR• 06Lt_ Iic;Rc
Legal Description: 1W-S 2 M;A J9 l�S12 9
ah 225
Property Tax ID#: .�11-3 $OI 006 — 000' 1 Lot No.
Site Plan Name: . C[r)L iLQ1414 V dfP ' Block No. IF2 _
Project Name:
Setbacks- Front 0 Back: IUIA Right Side: 2A —Left Side: p
DETAILED DESCRIPTION'OF WORK:
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� � �i �,�f SFW m to 26a
CO:NSTRUCTIQN.INFORMATION:
Additional work to be oerformed under this permit-check a appy:
HVAC Gas Tank ❑Gas Piping _Shutters Windows/Doors
Electric 0 Plumbing OSprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S .Ft.of First Floor:
Cost of Construction:$ ,ado.0o Utilities:nSewer ElSeptic Building Height:
OWNER/
LESSEE: CONTRACTOR:
Name Name: l� »ay1'4S
Address: 5 1712P-
City:
� Company: � 1/l/l C�br►[.$Li
City: State: ,. Address: (�)qa: ' IR-
Zip Code: ?, � Fax: qjq — �1�[ggg7 City: �6a;l- pip�rx State:�t%
Phone No. 'Ira- .332-- 1-1606 Zip Code: Fax:
E-Mail: Phone No. Z s
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License: I 7&ZLY C,6C ' 25s9q,
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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!` �RECETVED
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HB'o4 2019
ST. Lucie county, Permitting
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3 7 3 9 D H t 1 GAP, 25
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