HomeMy WebLinkAboutPermit application ALL APPLICABLE INFO/MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I I
Date: (� 6 Permit Number: I L V-
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: To Select from dropbox, click arrow at the end of line
Address: �� (�nSO���� �— ►�I'C� (
Legal Description: CkV\1 Atf'CJ
Property Tax ID#: _ Dd d 1 _ 000 t o Lot No.
Site Plan Name: C��� ,A Block No.
Project Name: C<ek�
Setbacks Front Back: Right Side: Left Side:
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F]HVAC Gas Tank ❑Gas Piping _Shutters Windows/Doors
Electric 0 Plumbing Sprinklers F�Generator Roof
Total Sq. Ft of Construction: [K6 S Ft.of First Floor:
Cost of Construction:$ Utilities .: _Sewer ElSeptic Building Height:
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Name: te' V�0 LUi Ct
Address: ;,. 6�t2 i;v.SUy��� C_� Company: S Tv�.G
City: �i -e- State:Et Addre�ss�'. s� I
Zip Code: /Fax: City: v o-V\CDct State:
Phone No. ��r �'[b�' 00 Zip Code: Fax: q5'1— 762—' cs
E-Mail: Phone No. 9?_r 09
Fill in fee simple Title Holder on next page(if different E-Mail: 0,, a Co w+
from the Owner listed above) State or County License: CC C 13x-$66 ZIf value of construction is$2500 or more,a RECORDED Notice of Commencement is required.