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HomeMy WebLinkAboutBuilding Permit Application All APPLICAB E 1N 0 MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: y �t Permit Number: p RECEIVED APR 082016 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: .CkALe,, PR©POSED INPROCC�/EME LOCATIC?N: �� Address: 11 L Y ma Coo,&- -t r L-u-t;,e, Legal Description: Property Tax ID#:' �y ��" 5ya " 33�, Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DE�S.CRIp'TION OF WORK: . 4. -r7i l - AA � J[C=,QN,SR,UTIO.N INFORMATION: Additional work to be performe 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:$ a� Utilities: —Sewer _Septic Building Height: Q NER/LE�SSEE: CONTRACT©R: Name ' \Ckv-o Name: fdA \lNtyk Addres : V-Ok- C Company: City: State: - Address: 15,�AMp ,1e. Zip Code: <640 TC�i'�> A Fax: �1 City: State: Phone No. �� r�`ic� �J�2-1' Zip Code: Fax: E-Mail: U{,\aC1\ lQ6A&VW 0 P one No_ Fill in fee simple Title Holder on next page.(if ifferent 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.