HomeMy WebLinkAboutAPPLICATIONALL 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 /
2300 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
Address: 5Q 30 +� A X Ad tip if 1 rC (p
YY 1I
Legal Description: RJI-i AK VP —IS�� LY % S l O l
Property Tax ID #: s 110 -- S 0 965" — orx) .-Ci Lot No.
Site Plan Name:
Block No. J
/
Project Name: �/� C' l YNPe UU 0o Y'Se 11 -
Setbacks Front Back: Right Side: Left Side:
0'k`O�_v-\g Li lti c ro n 5
Q�C <,Ic rv, . —710 Luc (- wot- rec,-u /'re
Additional work to be e orme un ert ispermit—c ec a apply:
ZVAC Gas Tank ❑Gas Piping Shutters
_ Windows/Doors
11 Electric In Plumbing Sprinklers ElGenerator
Roof Roof pitch
Total Sq. Ft of Construction:: S Ft. of First Floor:
`/
Cost of Construction:$ `5_00 Utilities: Sewer Septic Building Height:
Name l/z(Q6/u,pl) Name:���OVI
Address: 5^30 0.le XQf78 i,o n i'r-Company: t>trtj X,2 r Ll eC.fa^ir. e,L a j'r
City: f 'QtC'e State: �L Address: Li�CII S�/�l'9h /J7egdow ALI
h
Zip Code: 3 V9 L Fax: City: t-'AI M C i' I Stater
Phone No. Zip Code: 71!�q 9 9 D Fax:
E-Mail: Phone No. _� 7 Z — Z ! I — 33
Fill in fee simple Title Holder on next page ( if different E-Mail: 10mpi Uo /{{,._�I pc{re'
from the Owner listed above) State or County License: (`i,� / 8! � p
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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