HomeMy WebLinkAbout Revised Permit Application 08/05/2015 12:01 FAX 001/001
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ALL APPLI BLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: l.Yr Permit Number: !,�_) .'- I ri�£a •• :
RECEIVED AUG 0 5.1015
Building Perm:it.Application
Planning and Dev'eloprnent 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 tine q ��
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Address:_� 36?hUi7'0 A_;PL /�/ZL 4�7t L�iGL �lf�/S�a
Legal Description:_ crr�� �-r,/� G/,, .. ; �'6'�L 7e- 2366 /13d Co¢ 3
Property Tax ID#: 3�9- 5�4, i' Z3 -O- g Lot No____ 3 _
Site Plan Name: Block No. !3�
Project Name:
Setbacks Front Back: Right Side: Left Side:
i, V717'1,4 r-eV P1
4AdFditPJ,n,F1wYrt1Re e Oun er t is permit-c ec a appy:
H _ Windows/Doors
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11 Electric ZPiumbing Sprinklers Generator a Roof
Total Sq. Ft of Construction: "
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of First Floor:
Cost of Construction:$ V,6 UtilitiesSewer Septic Building Height:
Name Gl/ !� :Name: d
Addiess: � enc/4n ��l 'Company: t '► �.�r ���
City: / dY� c5_1 G'U e_ State: 1-6 iAddress: W ri.V'k'�-' v
Zip Code: F�7rS`.Z Fax: City: y c�' S'�'- ,-+/�t^�- State:.
Phone No. -7/!Tr- 753- .533/ Zip Code:�d Q\ �1 Fax:i1 "'Z JA-"lb.lo�
E-Mail: .Phone No.
"Oil PA
Fill in fee simple Title Holder on next page (if different E-Mail'� nntinrnpbGrtcan��►r� b1v;�, *.cvt+
from the Owner listed above) State or County License: C..-r,(- ' Ao
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.