HomeMy WebLinkAboutBuilding Permit Applicationa
ALL APPLICABLE IN-FFO' MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: Permit Number: l I I a - O !�
Building Permit Application DEC / 5 2017
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
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PERMIT APPLICATION FOR: p
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PROPOSED IMPROVEMENT LOCATION`Y"`
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Address: O V\
Legal Description:
Property Tax ID #: 1 "0 (a ) a - 0) DO 0 0 o- 7 Lot No.
Site Plan Name: Block No.
Project Name: (/o d—V Jb 'PAie/y .
Setbacks Front Back: Right Side: Left Side:
DEl'AILEDA ES`CRIPTION OFt,WO,RK as 4° hs w y k �' �xa`y'
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CONSTR'UCTIOWNFORMATTION 4 i
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Additional work to e e orme under this permit— check a apply:
11HVAC E] Gas Tank Gas Piping Shutters Windows/Doors
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Electric 0 Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: ( 00 S . Ft. of First Floor: 6_00 /
Cost of Construction: $ QV . Utilities: uSewer'SSeptic Building Height:
OWNER/LESSEE
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Name: =_C h in I 0 f/,yc ri
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Address: �d !�
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Zip Code: 3 i Fax: —-
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Phone No. Z 72 - (-e- 7
Zip Code: Fax: 77Z-7o ��
E-Mail: —1MUM
Phone No. 772-- OZV � — 3 3
Fill in fee simple Title Holder on next page (if different
E-Mail: V .VI 2 i Nl — q;^c(a U & . <opm
from the Owner listed above)
State or County License: CCG[ 3 3 130 ,,
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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Expires 1/20/202
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REVIEWS
FRONT
SUPERVISOR'
PLANS
VEGETATION
SEXTURTLE
;MANGROVE
COUNTER
REVIEW
REVIEW
"REVIEW,
;REVIEW
W
REVIEW
DATE
..RECEIVED',
DATE
Rev. 8/2/17