HomeMy WebLinkAboutBuilding Permit Application, OhioV fJ
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: O�
•
"'�' 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 APPLICATION FOR: To Select from dropbox, click arrow at the end of line
EO IMPROVEMENT LOCATION:
Address: � 0 9;> rOv"Q—c
Legal Description: Vi6
{ A,", S,/V �a n
Property Tax ID 4: ?jri -:z.Z l70--q = C>oc, Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
pltA ED DESCRIPTION OF WORK:
� t�s : a-`� �.l�w 5� '�-�f.n.� i•l,r`-c�� Raa�L>SF�
commuCTK)N INFORMATION:
Additional work to a er orme under this permit— check a app y:
❑HVAC nGas
Tank ❑Gas Piping _Shutters ❑ doves/Door
�Elettric Plumpbi�ng ❑5prinklers Generator Roof 4 L ooi pitch
Total Sq. Ft of Construction: "L-1 yl dO Sct. of First Floor: /
�Sewer❑Septic
Cost of Construction:$ (2, Utilities. Building Height:
'OV*R/t.ESSEE:
CONTRACTOR:
Name
Name:
Address: Z"A0N
Cmpany:' S �(
City: �i'apT ! r, —. L c 1 s_r. State: t— L—
Address:
Zip Code: Cj5j Fax:
City: I State:
Phone No.
Zip Code:2,�0 Fax:
E-Mail:
Phone No. 1 `7 7- — a�A 5ii — 2`7 3 5
Fill in fee simple Title Holder on next page ( if different
F-Mail: !�L»..f_ A P Pa, Gg `LAA L-, ClJ
State or County License: N
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.