HomeMy WebLinkAboutBuilding Permit Application ALL APPLIC BLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ` 1 Permit Number: 1 ��1- 0015
_ RECEIVED JUL 012015
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,port Pierce FL 34982 �
Phone:(772)462-2553 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from drophox, click arrow at the end of life
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Address:, �_ - i
Legal Descrip it on12 `%\J("Q- ' 1 �C� LOT D-L
Property Tax ID#: 0 Q 1915A 0(015- Lot No.��
Site Plan Blame: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
C-111 Pfi"-
ES P1.
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Additional work to be nertormed under this permit—chezk checkall app y:
HVAC Gas Tank F]Gas Piping _Shutters Q Windows/Doors
11 Electric a Plumbing []Sprinklers Generator Roof
Total Sq.Ft of Construction: 5q�Ft.,of First Floor:
Cost of Construction:$�ccc}•1 Utilities: USewer Septic Building Height:
:
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Name...C'3114-�In Mame:
Address- Company: 40-�OCP" CU cr 1 =-4 9 f mf 2n
City: C��C State:_ Address:
Zip Code: it Fax: City: �-v(1y'W State:
Phone No. Zip Code: 3-a l' - Fax: _
E-Mail: Phone Nor
Fill in fee simple Title Holder on next:page(if different E-Mail:
from the owner listed above) State or County License:
If value of construction is$2540 or more,a RECORDED Notice of Commencement is required.