HomeMy WebLinkAboutEveringham Permit page 1All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
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Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Permit Number:
Building Permit Application
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Commercial Residential
Address: 50Z4_ ?e_'XL�, Fla :7'08�
Legal Description: e-iPi76- ct% 3-1F IF0 (lf S� 3� _ �Jd sy� �r� -6r �� �S A�CIAJ
Property Tax ID #: 3 Y®3 - .50 2 69 79 " CDC) - 5 Lot No.
Site Plan Name: Block No.
Project Name: C&
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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(11 t31606- GJACa- 60f7ee-m 1A)J74eL- 57 ` Of 5 _2(,L- Ci44&JV 4_ '(-<4
CONSTRUCTION INFORMATION: _
Additional work to be pertormed under this permit - check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
Electric _ Plumbing _ Sprinklers _ Generator Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ '::) :3��-1
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name A) ViL (Sy&�vAAHAj+j
Name: g®`3&'P—i SanAaog_
Address:�562(o ��.11___1S�� D
Company: e6'."c-,'�x� L-d--C-
City: Fogg ?Idw_e� State: r(-
Zip Code: -3' �1y8 1 Fax:
Phone No. tab'. A (o38 - S®'2�'--
Address Z-?4'3 5�_, ` oc.x_i.1.4X % rT
City: �J ,ry e-ciC.rcT- State:(
Zip Code: .3L11:17 _'!� 3 Fax:
Phone No - 6l
E-Mail: 037 i3EVac-5- • C67M
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail 60°°_7
State or County License _20 r 6 i
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.