HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL 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
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: -760 C4R,
Legal Description: po� Ig p U,6 It
Property Tax ID #: 1 � 22- t 00 - 011 lri 000 - 2) Lot No.�
Site Plan Name: Block No.
Project Name:
Setbacks Front Back:
DETAILED DESCRIPTION OF WORK:
Nka UIVAZ"k 0-� 5 5 c
Right Side
Left Side:
CONSTRUCTION INFORMATION:
Additional work to be performed under tis permit -check all that appy:
HVAC LJ Gas Tank ❑Gas Piping ❑_ Shutters F]Windows/Doors
Electric ® Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction:
Cost of lonstrfiCt1 11: $ 5
Sq. Ft. of First Floor:
Utilities: u Sewer f =1 Septic
Building Height:
OWN'ERAESSEE:
CONTRACTOR:
Name iV'V
Name: 5*Y0 0
Address: f , U
JJ
Company: 4W -1I t
City: State: f -L
Zip Code: 22h4& Fax:
Phone No_ G ai Q -n
Address: -/ ALC)
City: PS E State:
Zip Code: 9 ' Fax:_
Phone No. -7-72 -T�
E -Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E -Mail: ihe—k-)Q � 4 C- I J1 CZL14
State or County License: ( p
If value of construction is 52500 or more, a RECORDED Notice of Commencement is required.