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 2/
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: 6-755 iL : - scy)
Legal Description: 000) "-S Pl ne!
Property Tax ID #: 7"6 — (9C1) -5 ` got)'& Lot No. 1 il
Site Plan Name: Block No.
Project Name:
Setbacks Front Back
DETAILED DESCRIPTION OF WORK:
Right Side: Left Side:
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CONSTRUCTION INFORMATION:
Additional war toa nertormed under this permit— check all that appy:
HVAC Gas Tank 0Gas Piping F]Shutters Windows/Doors
Electric ® Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $
Sq. Ft. of First Floor:
Utilities: 0 Sewer []Septic
Building Height:
OWNERf LESSEE:
CONTRACTOR:
Name .; C� ��
Name: V1 "t -o Y01706 -,--
-,--Address:,%;2-)
Address: (;-,7 ;2-)
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Company. F'(p'ediT ��
City: j/3 �� [Ue—State: FL
Zip Code: � "/ 5,� Fax:
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Phone No. 10 "'/ 51E
Address: 0 2 (l (VL U � �yp � ' e,
City: go�--v S I L U ( State: FL
Zip Code: 3il Fax:
Phone No. -77,-)---?77--(20/0
E -Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E -Mail: Vt l hC 00. WM
State or County License: C /
It value of construction is 52500 or more, a RECORDED Notice of Commencement is required.