HomeMy WebLinkAboutLAPLACA PERMIT APPLICATION1'
ALL APPLICA LE IN O UST BE COMPLETED fj R APPLICATION TO BE ACCEPTED
Date: y
Permit Number:
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Planning an OevelopmentServices . U Idrng Permit Application
Building and ode Regulation Division
2300 Virgini Avenue, Fort Pierce FL 34982
Phone: (77 462-1553 Fax: 772 462-1578
( ) Commercial
PERMITA PLICATION FOR: Residential_
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Legal Descrip �on; Sit /G,npe. (-406 u
Property Tax #:
Site Plan Na
Project Name L-I
Setbacks F nt
Back: "Right Side:
Left Side:
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Mom W t0 e er Orme' Ut1 ert Is
�HVAC Pefmit—c ec a aPP Y:
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j� Gas Tank ❑C„_, Piping
Electric _ Shutters
Plumbing Windom
Sn Jnklers Generator �j
Total Sq. Ft of onstructlon; �1 Roof
Cost of Constr ction: $ m S Ft, of First Floor:
Utilities: Sewer
e Septic Building H
a
Name
Address: 0 ebb =' Name:
eut�, r,
City: �a/ 5i' Luc;,.0 � Company: rtwvyd {�L-�
Zip Code: 1) State: L
Address: b611 Nam„ Ic
Phone No.
—3`i'S—Sl}lo � city:
E-Mail: — ZIP Code: Fax:
FIII In fee simp a Title Holder on next page If di Arent Phone No ^1la — y b�— 1313
from the Own r listed above) E Mail:m Fwyiwe
State qr County License: C
If value of const uctton [s $2500 or more, a RECOROEl�t,Notlae of Commencement Is required.
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No. H )
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Name:
MOfYir3AGECfjMPANY:
Address:
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Name, — Not ApplIc
ble
City:
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Addreso;
Zip:
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Phone.. - -' �--
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FEE SIMPLE
WOLpER:
Zip, p: State
Zip : Phone:
Name;
_ Not Appikable
BONDING COMPANY:
Address:
Name: —Not Applic
le
City:
Address;
I
Zip:
Phone:
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Zlp. � Phone:
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