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Building Permit Application
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: (o Permit Number: care -is I ON 11111, 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 .0 Residential X PERMIT APPLICATION FOR: Other PROPOSED IMPROVEMENT LOCATION; — Address: S•a�Yl. W 1 �� ry� �G(i'1.51`L �ndDminl L.l-m _' UPI (Co Legal Description: Property Tax ID #: �� - �a ' ©! J` I V ' �� ' 7 Lot No. Site Plan Name: Block No. t,, l� ,, Project Name: � C C l_ni t 0z:. Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: U a`�v-b bye.. N[ L Ch&nc C OWC WafeY60urCk Nem fkrnp �-i rs+ brn nc� 3 ibQ NO KYv i _5 ELK . CONSTRUCTION INFORMATION - Additional work to be Dertormed under this permit -check a appy: Gas Tank EGas Piping Shutters Q Windows/Doors HVAC _ Electric Plumbing OSprinklers Generator Roof Total Sq. Ft of Construction: SFt. of First Floor: 2500.00 []Septic Cost of Construction: $ Utilities:cn Sewer Building Height: OWNER%LESSEE: CONTRACTOR: Name Name: Kim Wilson Address: I Q(A C t.1.1 (LD p I— Company: Premier Plumbing & Air LLC City: (ftiVP- rne_,5S State: �L Address: 108 NE Dixie Hwy City: Stuart State: FL Zip Code: 344-3 �J Fax: Phone No, ?�;5 21 6 3 Zip Code: 34994 Fax: 772-692-1094 E -Mail: Phone No. 772-692-2500 Fill in fee simple Title Holder on next page ( if different E -Mail: preplbgac@gmail.com State or County License: 25222 from the Owner listed above) If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.