Loading...
HomeMy WebLinkAboutBuilding PermitALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: s Building Permit Application Planning and Development Services Building and Code Regulation Division 230D Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION: Address: q&Q5 ���p" a""'' t no- A�\,�z • fii trna, 34Q51 Legal Description: - L�,L.i w00pf y,Ini- I A A (f Property Tax ID #: 13p( -47 10 - 000 2 " 06V - Lot No. Site Plan Name: Block No. Project Name: Setbacks Fr Back: Right'Side: Left Side: DETAILED DESCRIPTION OF WORK: I,�ke Fy li(ce :41Sfut( 3 -1vv, or, I Qnrwx sPl�r �t 5 J,S+tn u)i-ek to tfw kea . CONSTRUCTION INFORMATION: Atiddythal work to be Derformed under this- permit -check a app y: HVAC Gas Tank ❑Gas Piping _ Shutters windows/Doors 1-1 Electric Plumbing Sprinklers 01 Generator 0 Roof Total Sq. Ft of Construction: Cost of Construction: $ 5000.00 S . Ft. of First Floor: _ Utilities:Sewer1:1 Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name lwU Name: Address:_&ps lliv,/0, Company: �-` City: at- ri f uz V State: _ Zip Code:-3LAI5l Fax: Phone No. -1-7 0-- ✓? Z I - 2&S5 Address:.510rJ pt--U,frl okq- F J City: I b( IRef(& State.: rt, Zip Code: '3 415 f Fax: -77-1- 4 0 -373-I Phone No. �_ Ltaf -4f+1 E-Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail:y7DVI nP trnh�apA�- Cn n State or County Licen e: CA-Ce I Z I n vaiue or construction is $zbw or more, a KECOKUED Notice of Commencement is required. t t t' �- 4 - # : :: � ""s --.. • };a r a `} - .. s � x 3e a;t � a.a a .. „�}: , ., `r [<.rshtC r s i Y � -`f } r ,e : •} a 3 k lax Hat Appkable State - Phone iiry -rVs ,{ fi - % F .. _ }` ` Ir i F f • i i# S'.f .t1S l t t' # ♦ a0 all # x f iat T. _ t i -- s ♦ sit- 4.� I j� j { d t 3 i f j Signature II4WT 16frywrier STATE >,IyAa xlaT�Va£!�3'CLVIIttSdi3i L6lYa5ae * >it£ ""•N� @awCyW �LgQgit�Y�IIga�.aYoyt�lfJ%�iif3lLLe J�BE�Aa cPV0�Fd9TALY£SEF2S9 COUNTYOF ii� {�.�l�� �fargmagax�straaaaesaasatas adummilledged GaCKRCatae Za+l- �v � Dee, . za � �, zR.�c�zai:'aia `� [i3t�t(g!•4lYWli�lili� before me acknowledged cttaZa daY at toc- _ zo'w by Type o#identification Prtxiuteot Type af2da±;3iicaieon Produced -FCC ,-tPf (Signature flfEaOV PisI state of mLUi2} (Signature of ticaiary i`:aA[I#3) i..}H1+l���t�aa iiiQ . Y �_`..............'. CHRIS' • YCE CONWEIL �y.. Notary Public - State of IT Commission X GG 98470t fomsaarfata tics. +�a�NCHRISTINE JOYCE CONWELL _ ; Notary Public •State of Fiortd► Commission X 8 ded through Nato al Noar n v res ug 21, 2024 REVIEWS Fi{ PLWSMW na � LiiUNi€R IiE3ff£iiV AEVt€Si# REVIEW REVIEW Fd DATE RECEIVED DATE j COMPiEI'ED t