HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: A ®(�
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Building Permit AppiiCati®n
Planning and Development Services EB a 3. 2016
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 -
PR ':POSED IMPROVEMENT LOCATiONTM r = -
Address:5"/()// S� �UR/Il�� fink G/Ts� l=L.
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Legal Description: LIyi o Aer-/I. G-"STilT�S-zfw,7 Gg - d LK 23 loz-5 .1 owp 27
Property Tax ID#: 3?�d'-fid Q-vDV eeo — t/ Lot No. ;24,,4-Z 7
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DET�4ILED�®ESCRiPTION OF WOR6C ; ? , ,
AC6 /W a V J# 0i"57 6a')/,
CONSTR�ICTIOl1B iNFORMAI-iON
itiona wor to e e Orme under this permit—check all app y:
HVAC El Gas Tank Gas Piping _Shutters Vvindews D r
❑ g / oo s
01 Electric 0 Plumbing ❑Sprinklers F]Generator E]Roof
Total Sq.Ft of Construction: SFt.of First Floor:
Cost of Construction:$ ��7� Utilities: Sewer®Septic Building Height:
DINNER/L�SSEI= _ � C�NTRACT�R _
}F: 4
Name i/621Ti= "'aCX Name:/ A/!g V,'7GA/�y/L
Address•LP'/O e APC ,t9 /L Company: gg45e//I,—_— GoA �' Qom- tE�
-l��72—f G r T� �T rs,>1,p �- ao���
City: State: Address:
Zip Code: 03 V MZ p Fax: IVA City: Pay-, T/_P!* G State:_15� ,
Phone No.A Zip Code: Fax:t�9 02
E-Mail: 4 Phone No.
Fall in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) 4tate or County License:
If value of construction is$2500 or more,a RECORDED Notice of commencement is required.