HomeMy WebLinkAboutwh appl. 12.17.2016ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
WGUARMT
_.
K 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
PROPOSED IMPROVEMENT LOCATION:
Address: 9VO-5 � i,-/Q� 1' T��]e ,1�Yd
Legal Description: r l/i� �3 T1l Tt1� t�i �1,L
Property Tax ID #:
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
e-0 c4 -6c
ill
Lot No. 3;1
Block No.
CONSTRUCTION INFORMATION:
Additional work to bfl
rtormed under this permit -check all that apply:
HVAC Gas Tank F]Gas Piping�MGenerator
Shutters Windows/Doors
Electric ® Plumbing Sprinklers Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 1895
OWNERAESSEE: 1� r
Name 1)tr�M,(, S
�i)'1,
Address: (VC r7�S I GI
City: PDQ2 _ t UAlCAe
P
Zi Code: 3� � Fax:
Phone No. (91 -� - �77 .�2
S�Ftj of First Floor:
Utilities: L_ISewer El Septic Building Height:
State:T__L
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR: c �,
Name:
Company: Eu acvA' �✓1G
Address:
City: �J0� J�7fUU�CJI State:
Zip Code:�Fax:
Phone No.
E -Mail: PSR n `i
State or County License: c t" c 1 q) g U O�Qq
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.