HomeMy WebLinkAboutScanned Section 58-1ALL APPLICABLLE� �NFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: rl I a'o 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
Address:
Legal Description:
Property Tax ID #: , Lrr boo QCd OCO -1 Lot No.
Site Plan Name: Block No. _
Project Name:
Setbacks FrontBack:
1]HVAC
11 Electric
Right Side: Left Side:
Windows/Doors
0 Roof
Total Sq. Ft of Construction: So. Ft. of First Floor:
Cost of Construction: $ Utilities: Sewer _Septic Building Height:
Name U V\h\ >'" W\V_tiZ '
Address: VP9D t r-i Lie,
City: State:
Zip Code:: # Gt `i 1 Fax:
Phone No
E-Mail: _
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Name: I �hk > L—a i- h
Company: as ('� Y `tt
Address:
City: -� `r� aC_k' - State: 1- L
Zip Code: Fax: -I'
Phone No. t �� 1(
E-Mail: V�1 `r J'VC� , b�r.�
State or County License: CT C.. Oc4 R a33
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.