HomeMy WebLinkAboutBUILDING PERMITAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: i -. 1. 0 1 y
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 Residentia
PERMIT APPLICATION FOR:
PROPOSED INPROVEMENT LOtkhbk "'
Address: t S• VS Bi Ce / 2
Legal Description: 1 �(X/ t b r`Ci (6 SID i Jul S ec IS �3 k A) I i( q i Cn
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Property Tax ID #: 20 r) I ( Lot No.�_
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
Additional work to be performed under this permit - check all that apply:
Mechanical _ Gas Tank _ Gas Piping _ Shutters
Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
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Cost of Construction: $ OCZ`f— Utilities: _Sewer _Septic
Windows/Doors
Roof
Building Height:
OWNERAESSEE:
CONTRACTOR:
Name V) 1'4%) i%-[(!Av i q i, C t-
Address:
City:R-kA
` ._ v l e State:IL'L _
Zip Code: e �t qSZ Fax:
Phone No. 0 o 0D
Name: f d,cxfYX
Company: "
Address: fit f
City: Ps L- State: -L
Zip Code: � \y �_%, Fax: U741Vi --Ot'90
Phone No ng 070 2.
E-MailL-1,WNP (\Y)P a0i - CoiY)
E-Mail:I
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Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License CAC i i6 cl & 3
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.