HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
C+[3i3 N T�
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
Address: Tb til
Legal Description:
Residential
Property Tax ID #: i .' `ccc)6- `-060- Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
c;� c; Lo aVe
CONSTRUCTION INFORMATION:
Additional work toa er orme un er t is permit -check a that appy:
HVAC E] Gas Tank []Gas Piping MGenerator
Shutters Q Windows/Doors
Electric �lumbing Sprinklers F]Roof Roof pitch
Total Sq. Ft of Construction: [�
Cost of Construction: $ 1
S Ft. of First Floor: _
Utilities:Sewer Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR: ,
Name UL i lam\ �
Name: �� - of
Al�- owoo t>VC-f
Address: R �.�
Company: -E-94i�
City: P -S f!_ State: FL
Zip Code: - Fax:
Phone No. ��� - i �% - ��
Address: tv/19 &W
City: Ps 1- tater
Zip Code: 2)'7 `1f� e Fax:
Phone No. '7!-2 -777-0d (�
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E -Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E -Mail:
State or County License: C�- i q ( (} C]
Tf
iT value oT construcnon is >Zsuu or more, a KKUKDED Notice of Commencement is required.