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knight1
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: _ 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 PERMIT TYPE: PROPOSED IMPROVEMENT LOCATION: Address:" t > Property Tax ID #: i '- ©DC�%- Lot No. 7s Site Plan Name: i sirdeg-✓ �c r/�� _ - _ _ Block No. 01�7� Project Name: DETAILED DESCRIPTION OF WORK: M CONSTRUCTION INFORMATION: I Additional work to be performed under this permit -check all that apply: -Mechanical - Gas Tank _ Gas Piping __.. Shutters _ Windows/Doors - Electric - Plumbing - Sprinklers T Generator — Roof Pitch Total Sq. Ft of Construction: Cost Cost of Construction: $ y 0 c Sq. Ft. of First Floor: Utilities: - Sewer ___. Septic Building Height: OWNER/LESSEE: CONTRACTOR_ Namebl'r/Cto Name: Address: 13 e> c l�r/c�c_ Qom/ f r'�P� �� T City: - _ _ 5 T- Z-yG r ip -State: P6- Company: -_ dq,5k, ✓-5 62!T2 P_ �Ci(i%-5 Address: / 5 S City: _ C,7 Stater Zip Code: Fax: Phone No. 4� T3 7 Zip Code: ��f � Fax: E-Mail: sic/ 6P�S, COa ii Phone No__-(_777a =Z�-760 Fill in fee simple Title Holder on next page (if different E-Mail Q3--v 6&5(t, 5 2 , tV, from the Owner listed above) State or County License_ 2,1 If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.