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Building Permit Application
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED { q Date: 'I `v��>'(� Permit Number: • Building Permit Application JUL ? 7 2016 Planning and Development Services P ER'Ji l-c7i NG Building and Code Regulation Division SL Lucie County, FL 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: PROPOSED INPROVEME COCA Address: /0 ��' i2�1 S�2/ ,LrV �r% �� a/•o, ;a Legal Description: Ale- Property Property Tax ID#: ''i I ' S©� �0�' I Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: [_DETAILED DESCRIPTION OF WORK: k,6NSTRUCTION INFORMATION: Additional work to be performed 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: $ _00Utilities: _Sewer _Septic Building Height: WNER/LESSEE: . CONTRACTOR: Name • ' Name: ocGrp l b . Address: !0 Company: City: �Or% Slr - State: e= Address: `f <2-C..) / c 1 r Zip Code: Fax: City: (4,r -r 44a-c.F State: Pt*'Phone Noba) V7,57-1 7/06 . Zip Code: .3 V{ s3 • Fax: E-Mail: Phone No(&2-) 3 K ` Fill in fee simple Title Holder on next page( if different E-Mail ��?it�toG/10 �9 "'�/4�0e core from the Owner listed above) State or County License 5_r,57- If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.