HomeMy WebLinkAboutBuilding permit appAll APPLICABLE MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
/INFO
Date: C� / / -
Permit Number:
r♦
le 7
.
* R
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: �Pr� 0/�-1�, 9�
PROPOSED IMPROVEMENT LOCATION:
-� /
Address: /07)_ Jr/S OCe4» ��. #,2y S.�s�� Gh • 3612V
Property Tax ID #: `7�Q�� ' OOO - Lot No.
Site Plan Name: 0��/ Qv / Block No.
Project Name: ;- y8
DETAILED DESCRIPTION OF WORK: -
r✓ hj �e 1�P 2�/p % - i 9.� c1 rl r2.� / O S 5 � ,S1f- /h 0 P Li orl P
/�
,Lo _vg
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit - check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors
Electric _ Plumbing Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: 5 �b Sq. Ft. of First Floor: Sst/
Cost of Construction:.$ 19,00•00 Utilities: fSewer _ Septic Building Height: �'ff
Name / �PVP,? /-/o» 6 Name:
T
Address: 220I I G�-Ala 67 1 Company:AWir,J dQd,::;,1-5-yc-, i»f
City: ,S�r/urf State: ICZ. Address: l 11/E _: j9e4Cel' SjI•
Zip Code: 31_19941 Fax: City: S,. fPn 1,?ea.c .S/State: L
Phone No. 508- 1'y4/1 - 985i zip Code: 31i75-7 Fax: 77.2-,2_3.2,2/9/
E-Mail: Phone No 772 '.3 7,1 -
Fill in fee simple Title Holder on next page ( if different E-Mail aL�4 rn ,sue �`�� � 4C e11aA1oo• Cow
from the Owner listed above) State or County License
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.