HomeMy WebLinkAboutBuilding Permit Application (2)ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
i f J
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:
����j -�%Cj -e_�
Legal Description:
Property Tax ID #: _313Y '__5QQ " CC)6 Y -'1! 000 7 Lot No. -5-
Site-
Site Plan Name:
Project Name:
Setbacks Front Back:
DETAILED DESCRIPTION OF WORK:
Right Side: Left Side:
Block No.
CONSTRUCTION INFORMATION:
Additional work toa er orme under this permit - check a that appy:
HVAC - Gas Tank ❑Gas Piping F]Shutters Windows/Doors
FNA
Electric LCA Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 9-15
Sq. Ft. of First Floor:
Utilities: R Sewer 0 Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Jo 1`\ o "
Name: �Q{l
Address:j, ( c
Company:
_✓yl
I 1 C:
City: PC; pl S` i ,� e State: �
Zip Code: 2) q q S v Fax:
Phone No. (3) — 110 - 1 Lf
Address: Nim
City: State: FL
Zip Code: Fax:
Phone No. -7W - 7,77" C)
E -Mail:
Fill in fee simple Title Holder on next page { if different
from the Owner listed above)
\Ong'
E -Mail: �� j 1 `�,C(2 1C)0t (DLVi
State or County License:
— __ ULLlvll 13 1e_JVV U< inure, a MrLUKUru Notice OT commencement is required.