HomeMy WebLinkAboutBuilding Permit Applicationu
All APPUCABLE.INFO MUST.BE COMPLETED°FOR-APPLICATION TO BE ACCEPTED
Date: _ a Permit Number: d y -0 5q 9
RECEIVED
Building Permit. Application APR 9 7.021
P/ann/nB.and;Developmeniservlces +rm,ttN g Department
SIC. Lucie Count
Buihding and'Code`Reguloilon Dfvls[on, y
23W Vi ginlaAvenue,:FdrtPierce FL,34982,
Phone: 177 ) 462-1553 Fax: (rnim462-1578 Commercial xx Residential
:PERMITTYPE. ��4� \
PROPOSEDfMPR`OUEMENT'LOCATL�N
Address: —5000 NW Dunn Road - Ft Pierce
Property Tax lD`#: 3403-502-0194-000-3 Lot NO.
Site Plan Name: Block No.
Project Name: Renovation for isolation room
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Renovation of two patient room to convert to isolation room
Additional work to be --performed under this permit —check all that apply.
m Mechanical _ Gas Tank Gas Piping , Shutters _ 1Mndows/Doors
_ Electric _Plumbing _ Sprinklers Generator _ Roof Pitch
Total Sq;'Ft of Construction: Sq. Ft. -of First Fioorc
_Cost of Construction: $> �1�, J Utilities: _, Sewer _Se ptic Building Height:
OWiER%iESSEE•
Name ' K Murray Fournle,
Name: Jahn Aiken"
Address: 1201 BE Indian St
Company: Mid -State Mechanical of Vero Beach:lnc.
City: Stuart State: FL
Address: 3825 71stStreet
Zip -Code: 34997 Fax: 772-403-451-8
City: Vern Beach State:- FI,
Phone No. 772-403-4506
Zip Code: 32967 Fax: (772) 778-8548
&Malh. mfournieStreasurehealth.org
Phone No r7721567-3102
:Fill In RS simpie TItIe.Holder on nextpage(Iif.different
: E-Mail sales@midstatemech.tom F
i Om'the Owner listed above)
State or County License #29961- St Luice County
State License # CMC056244
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