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Building Permit Application
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: 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: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION: Address: Irlgq ow bis I.. cif Legal Description:rA,, bo,r beef Moss Vito ci cc PropertyTax lD#: 4q 7% ©016 OO oq Lot No. 6 Site Plan Name: }aw w&- �Si°te n - Block No. Project Name: V,,- Setbacks Front Back: Right Side: Left Side: DETAILED"DESCRIPTIOIV OF WORK: ' IM Is CONSTRUCTION INFORMATION: Additional work toe e orme under t -checkispermit a appy: HVAC 11 Gas Tank E]Gas Piping _Shutters Windows/Doors Electric ❑Plumbing Sprinklers E Generator 1:1 Roof Roof pitch Total Sq. Ft of Construction: S . Ft.of First Floor: Cost of Construction:$ Z-2-00 � Utilities:nSewer Septic ;. Building Height: OWNER/LESSEE. CONTRACTOR`: Name%. 3 Name: L,jr-4-%5 I LIC- f Address: 114c NV CJ`(' Company: C_b (Z 3oAcL r5 C.or� City: f IJ r\ UL, State:EL Address: 3Z-31 SE Dv:r ti•1�� 1�r Zip Code:Lt 9 9 D Fax: City: 51-✓c,.l State:_L_ Phone No. L $5 " 461 of- Zip Code: Y 191 Fax: E-Mail: Phone No.rM_ ZS-0S_ Fill in fee simple Title Holder on next page(if different E-Mail: LDR- Z>j► L o P-k from the Owner listed above) State or County License: 31,L 2- C-&c- I q if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.