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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION To BE ACCEPTED
Date:
Permit Number:•
Building Permit Application
Pionning and Deve/opmentServices
BufYdhW and Code Regub don DivPshm
.2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-3578
Commercial Residential =. om
PERMIT APPUCATION FOR: To Select from dropbox, click arrow at the end of line
41: _ .—
Address:
Legal Description:
Property Tax ID S.�A G� z la s Lot _No.
Site Plan Name:
Project Name:
Block No.
Setbacks F
rant Back* Right Side- Left Side:
DETAILED DESC RIP7104 OF WORK
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CONSTRUCTION INFORMATION.
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HVAC Gas Tank ❑Gas
a app Y -
Piping
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Electric 1 Plumbing nSprinklers
_ Shutters
Generator
Q Windows/Doors
Roof
Total Sq. Ft of Construction:
Sci. Ft of First[ Floor:
Cost of Construction: $ G'c> Utilities Sewer i a is
Building
,J
g Height:
Address: (U 7 0 C- C= LC ✓d 1
City:-- f2 c,2, ( State: 'f
Zip Code: 1-/ 1 I `7 Fa):
Phone No. -j
E -Mall:
Fill in fee simple Tale Holder on next page (if different
from the Owner listed above)
CONTRACTOR:
Name: John R Law
Company: Law's EkxMcal SerAm Inc
Address: 5458 NW Nmm St
City: PT ST Lucie State: FL
Zip Code. 34983 Fax•
Phone No. 772 370 4357
E -Mail: johnWwSI58@aol.com
State or County License: 29432
If value of conSDUCthm is $2M or more, a RECORMI) Notice of Commencement is required.