HomeMy WebLinkAboutScan_20220303All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: M 3i Z Z., 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 Residential
PERMIT TYPE: � � ,, ,� N
LO
Address: �_l i, C)Onc \C
Property Tax ID #: Do `` 7� Lot No,
Site Plan Name: Block No.
Project Name:
Additional work to be performed 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: $ 1 t "50• 0 0
Sq. Ft. of First Floor:
Utilities: _ Sewer _ Septic Building Height:
Name '_43,,xk-cL(-,-, �'C'A-VA,;'�4
Address: )32� v,,e .5 e-�5 1 uv-4-
City: 6-Ci.-t-Sr.i c State: 10
Zip Code: 1 1 `1 30 Fax: k.) !}°
Phone No.
E-Mail: c-r v .1()Vvr : r,F, % 1...,�Cr`u.; i . Cry n
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name:
Company:2..t
Address: LA
City: C State: C
Zip Code: S -0 1� �)' Fax: A, A•
Phone No -4 `l (o 71 -
E-Mail G� �+-+--c ,; A t
State or County License C C, t q 7 3 1
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.