HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED //�� ��jy(�Q
Date: 5+L/ '2y Permit Number.oC00S• op,0 /
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 APPLICATION FOR: AV ww Ill Cue,
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Address: q
Legal Description:Qui eNS G)Vt Ut_j 1 '20 Lai L
Property Tax ID#: `i I q 701 0,4 C)14.— ®Opp ki Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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Additional work to be pertormed under tis permit—check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: / r Sq. Ft. of First Floor:
Cost of Construction:$ / ! Utilities: —Sewer _Septic Building Height:
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Name 1t1. Name: ,e_WL
Address: ir e j Company: ,t
City: MiAAa J, (N.SOn State-P— Address: C1 o )
Zip Code: Fax: City: State'
Phone No. Zip Code: �Qf Fax:
E-Mail: Phone No "�."�_a- k4t i 'LO(Q
Fill in fee simple Title Holder on next page(if different E-Mail Y i iN
from the Owner listed above). State or County License
Iff value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
DATE: 3Cj
7G ,MAIL-
ESTIMATED
•ESTIMATED LEADTIME:
HAME: C-0
ADDRESS: c�X12 5 i !
CITY: O VB SIT ISI, ZIP:
PRODUCTILF.DESCRIPTION: &Voye WI N S�' I/
a ALUMINUM COLOR 36 KEEP FENCE BOTTOM ON GROUND NOTES:
�%-MNYL COLOR 6, KEEP FENCE TOP LEVEL
ri CHAIN LINK COLOR ❑ LINE CLEARING REQUIRED t�ca� cale
a WOOD TYPE ,t
)i 4'H WALK GATE SIZE l�
n 5'H ❑ DRIVE GATE SIZE
n WH
TOTAL PRICE $ `cl a `All esdlmates are valid for 3 ys
50%DEPOSIT $ t �� CUSTOMER ACCEPTANCE-
BALANCE DUE ,-
of
AT COMPLETION$ DATE:
Esdmated start dates are subject to change due to natters of weather,metedei vendor defm^and goverment
perar Wng delays.All deposits re9unds are subject to adminisi mt&on fees,matocking foes,anndlaborfees.
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