HomeMy WebLinkAboutbuilding permit (2)ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: IaZ I_ ti(ZO Permit Number:
Building Permit Application
Planning and Development Services
Bjriiding and Code Regulation Division /
2$00 Virginia Avenue, fort Pierce FL 34982 V!
Phone: (772) 452-1553 Fax: (772) 452-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: T t7 S SM(fG� rXA s ro T� CrCP/ 3�5
Legal Description:
PropertyTax ID P: Z3 L7 22 00) D— 000 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
�Vl Is�Ci�l LQl�nax ter �� 5 �� sT 14 >`l 51sttpn
CONSTRUCTION INFORMATION:
�ti a or to �e�e! orme under is permit — c ec a app y:
❑Gas Piping Shutters F] Windows/Doors
AC LJ Gas Tank _
_
ElElectric 0 Plumbing �Sprinkiers 0 Generator L ( Roof
Total Sq. Ft of Construction: 5q� Ft.� of First Floor.
S4ID
Cost of Construction: $ .60 Utilities: LJSewerSeptic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
s
Name:
Addres : 8 S. 1 O SVVI
Company: ` l YPa
J '
City: r� Pl ��CState:
Address, �J A CfYIA(k4- A, R (
city: State: R.
Zip Code: a`I5 Fax:
Phone No. S
Tip Code: 31051 Fax:-I?X LI&O-3731
E-Mail:
Phone No.' ra_ `YPJ -41 k l
Fill in fee simple Title Holder on next page ( if different
E-Mail:f
State or County Licen e: % 12,11 l S I $ (y
from the Owner listed above)
If value of construction is $25W or more, a RECORDED Notice of Commencement is required.