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Building Permit
ALL APPLICA LE INFO MUST BE COMPLETED FOR APPLICATION To BE ACCEPTED Date: I 2) Permit Number: ® Building Permit Application Planning and Development5ervices B*i1ding and Code Regulation Division 2300 Virginia Avenue, fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential P€RMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION: Address: U-7to wGt(�4i� IPhd V(1'1ft m rV &AqL15 Legal Description: Gbl 0y1 VMS Property Tax ID #: M0344 t-17b?15-0 0 Lot No. Site Plan Name: Block No. Name: Project Setbacks Front Back: Right'Side: Left Side: DETAILED DESCRIPTION OF WORK: i Ili �r l lk� - fos-Fpt Intw lk�C To&af les to heat . CONSTRUCTION INFORMATION: ' tti a or to eDe� orme un ert-Ispermtt-c ec a appy: HVAC L1 Gas Tank [_]Gas Piping _ Shutters E]Windows/Doors 1-1 Electric EiPlumbing ®Sprinklers 0 Generator 0 Roof Total Sq. Ft of Construction: S Ft. of First Floor. Cost of Construction: $ Utilities:0 Sewer n Septic Building Height: OWNERAESSEE: CONTRACTOR: Name 0 l C. Name: Address: viol WnW 31si-M Company: £ City: tJ State: Zip Code: 33D _— Fax: Phone No.-"?,Mnt=%i%YUrU1'Pb1A-5 413-33a-I)B2S Address:5t© I+TLcrvl�'1 p— aC�64::& City: (?1Ck f�47fceState: Zip Code: '3 5t Fiax: ?�"�i'nlP PhoneNo.�-9�-1tt`i i E-Mail: Fill in fee simple Title Holder at next page ( if different from the owner listed above) E-Mail: �n State or County Licen e: C r,118 l $ l $ (9 If value of construction is $25M or more, a RECORDED Notice of Commencement is required.