HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: f'D 2 Permit Number: Il 0 ( 1oZ ,
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wIllmm.. µ . 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 I/
PERMIT APPLICATION FOR:
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�PRQR®SEDy�INPROUE31ENT�LO�A�TIO
Address: L10 b il All
Legal Description:
Property Tax ID#:_ 1 �7 -703 . C966 f Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAIL.E'DDE-S MPT ( N OX.
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CO. STR'IJCTIONINFO MA�'TION"
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itiona wor to a per Orme uncler this permit-check all tat appy:
_Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors
Electric _Plumbing _Sprinklers - _Generator _Roof
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Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction: $ Utilities: _Sewer _ieptic Building Height:
OWNER%ESS£ . : ® T
Name Gq,�1 i,-1 ��>7�.1_4?�l\9 r' Name:
Address: too 06k (r7, (.i Company: fm��rhj LG r �C
City: '1^T 'Pre r c-g_ StateT-C. Address: l oc-i
Zip Code: Sl Fax: City: 1061fl E LL/L i`.e State:L
Phone No. Z� �77 /"2 Zip Code: 3�°! 5'3 Fax:
E-Mail: Phone No !4
Fill in fee simple Title Holder on next page(if different E-Mail (x, t4t4 _4 _nIlli
from the Owner listed above) State or County License l
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
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