HomeMy WebLinkAboutBuilding Permit Application r
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: L\1$ �� y
—� Permit Number:
RECEI�,�p APR 0 � 2�1�6
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:
PROPOSED IMPROVEMENT LOgCATION'j, , r ' ' ; 5
Address: '2203 „Fru�L
Legal Description:
Property Tax ID#: 2 y,?e_ 602 (000 Z-1 " WO Lot No
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
:DETAILED DESCRIP77
TION,OF'INOR�C ' `
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`CONSTRUCTION INFORMATION u r `' `ti
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Additiona work—to-Fe—pertormed un er t is permit-c ec all that app y:
_HVAC _Gas Tank _Gas Piping _Shutters _Windows/Doors
—Electric _Plumbing _Sprinklers _Generator Roof
Total Sq. Ft of Construction:_ _ Sq. Ft.of First Floor:
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Cost of Construction:$ 3'1�(o0 - Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE; `h„ i CONTRACTOR " r
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Name ��� ;,P p �1 P 1— Name: nS C�Z x`2 0 L. 1J
Address:. 2')o_ b �d Company: aeQa-. t C0 Q
City: 'M%X_ S�L. C-�zc_p State:L` Address:��A,vA.,P_C py
Zip Code: Fax: City: to �o . 'K DQ\t 3 State.-3,—
P h o n e
tate:Phone No._t`��- J '222 — Zip Code: Lf lk Fax:
E-Mail: Phone No.( 5q
Fill in fee simple Title Holder on next page(if different E-Mail:,,_p
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from the Owner listed above) State or County License:C i'�C. /5z 15c),3
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.