HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: /ao /1(o Permit Number: j(pc�
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:
Address: 5a H �i lue,- 00K 6r;vv-- , Acna r FL 3498a
Legal Description: =,-J ion � En-fn
Property Tax ID#: 3gOa -LvOLv -D)4q -OOD Lot No. 18, 19 4-20
Site Plan Name: Block No. a5
Project Name: Fd4-)C�
Setbacks Front 15o Back: Right Side: Left Side:
A i n Z.)n Lo iill GUOC6e
e - L1 } . �a�-e on k-
Additional work to be pertormed under this permit-check all that appy:
_Mechanical _Gas Tank _Gas Piping _Shutters _ Windows/Doors
_Electric _Plumbing _Sprinklers _Generator _Roof
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction: $ l 9bo Utilities: —Sewer —Septic Building Height:
Namer-' - 1' Name: �G+mG Q� Orc�r��
Address: 5a1L4 5►f'yG- 00K &ri u _ Company:
City: F,-+ Pie-r State:FC_ Address:
Zip Code: 3498 , Fax: City: State:
Phone No. -77,P_ - 34a - .214144 Zip Code: Fax:
E-Mail: Phone No
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 2500 or more,a RECORDED Notice of Commencement is required.