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All APPLICABLEINFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �) ItckZ -- 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
PERMITTYPE:
Address: Qs b -1 P 4LV ci-y3 o No env e_
Property Tax ID#: I-Aa� - -70,) - O'AaI - 6c) 1 - o
Site Plan Name:
Project Name:
Additional work to be performed under this permit -check all that apply:
Mechanical _ Gas Tank _ Gas Piping
Electric — Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $
_ Shutters
_ Generator
Sq. Ft. of First Floor: _
Utilities: _ Sewer i Septic
Name Alo,.'Zv law nit."co�'p PA
Address: �. o 6
City: ? -r _ s . L ., C- State: rC
Zip Code: _ . `AA Fax: ) A-
P ho ne No. '-I %,7_ - (Q 6 a - `Z., Z.16
E-Mail: r'eca),.-koi•L CbL-,) (OM
Fill in fee simple Title Holder'on next page ( if different
from the Owner listed above)
Name: tx�t-f� i-�r-i
Lot No.
Block No.
Windows/Doors
Roof Pitch
Building Height:
Company: 12.e.t °to k)s C-4
Address: 4 ") A {
City: Y ; r-C (_4 State: i C
Zip Code: 3 -0 i D- Fax: Aj ;A
Phone No �l-i L' (� 71 -
E-Mail
State or County License C r C. 4 `-1 7-
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.