HomeMy WebLinkAboutBUILDING PERMIT APPLICATION 3-1-18J r.
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ������
�• I Permit Number: V
`�$�.Ud� C®Ui1tv RECEIVED
Building Permit Application MAR 012018
Planning and Development Services 5T. Lucre county, Permltting
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPtOSED°i.MFROVEI ENTIOCAT1.0 , 3
Address:
Legal Description:
Property Tax ID #:
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side:
D Lot No._
Block No.
Left Side:
DETAILED DPTION
ESCRIOF WORK�r
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Additional w6r-R—to-T—e—Dertormed under this permit— cNeck all
apply:
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❑HVAC
Gas Tank
❑Gas Piping
_
Shutters
❑
Windows/Doors
❑
Electric
❑
Plumbing
[]Sprinklers
❑
Generator
❑
Roof
Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ .50 t D 0U . 00
SIn
of First Floor: _
Utilities:Sewer ❑Septic
Building Height:
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OWNER%LESSEE e
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Name r o Up- r A a6
Name:
Company:
Address: P!
Address:
City: F` , e o c(! State:
Zip, Code: Fax:
City:
State:
Phone No. �7�7�� �r'i % —� f C/
Zip Code:
Fax:
E-Mail:D�nOGi!/P4��QD', L'040
Phone No.
Fill in fee simple Title Holder on next page ( if different
E-Mail:
State or County License:
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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