HomeMy WebLinkAboutBenson Permit App 1ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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 z Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address:..-4-1 i'A k, e
Legal Description:
Property Tax ID #: Fr L - Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
f_6V__ L.) 414— lleJ�
114:Ll k, & An s vo 14--S a r%?,w 914ww4b 4,v �r_ ini IIi d
CONSTRUCTION INFORMATION:
Additional work to be Derformed under this permit- cfieck all apply:
EHVAC Gas Tank ❑Gas Piping In Shutters Q Windows/Doors
Electric ❑ Plumbing Sprinklers []Generator 0 Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $
Sq. Ft, of First Floor: _
Utilities: l_I Sewer D Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name ' Pl.
Name: tc" G t! L` QU(-nP'aA"
A
Address: 1 (All CL' cgs
Company: _i�P.Ay 4-z:'
r1
City: G State: L_
Zip Code: 4q Fax:
Phone No. S (Z' -
E-Mail: C�,e� 6. py I G lu GQ(y)
Address: �7o n
±a n e'd oL rCyi�i
City: -To ( : i? ((-'0
Zip Code: q 7
Phone No. 6-
State:�rL
Fax:—! 72— - q 6 6 -i)5170
Q
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: ( (IV +Z I /i G
Nn , GdA1,
State or County License: F. CA
S OO SS I
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.