HomeMy WebLinkAboutBUILDING PERMITAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: 1 LI t ' Qluq
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: ��U� US Wq ow i 1yc iri• '5'I Cl 5 -z -
Legal Description: M� � (c�►^o� (`yS �� � � /� SIP(- 15 3(o 44)
Property i ax iu tt: L %J — 1 u
Site Plan Name:
Project Name:
Setbacks Front Back:
0
Right Side: Left Side:
Block No.
Mechanical _ Gas Tank _ Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $��� Utilities: —Sewer —Septic
Windows/Doors
Roof
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name r' -t,) V
Name: cy iA f- t
i
Address: ) S
Company: �'
Address: 7 CA i
c— S�
`�`
City: P (uA_U State:
Zip Code: l Z�/ Fax:
Phone No. 'lSo 0 L
City: Ps U
Zip Code: ?A9 � _L S
Phone No (17Z) OZN ^ 762
E -Mail A:� h 0(\e—
State:��
Fax: 072) 2 Z� - e)giD
(an 1 c t)iy)
E -Mail: la&M4
t
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License C'_80-
I :2 l 3 U95
If value of construction is 2500 or more, a RECORDED Notice of Commencement is requirea.