HomeMy WebLinkAboutBUILDING PERMIT ALL 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:_� C 0
Legal Description: S� i�� � Vl Cn
Property Tax ID#: '�� �0 '� �✓ Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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CONSTRUCTION INFORMATION:
Additional work to a er orme under this permit—check a t t app y:
OHVAC f]Gas Tank ❑Gas Piping Shutters Windows/Doors
Electric �Plumbing Sprinklers Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ Utilities: 0Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Y1nv—' C @0 Name: S .fl y) Y6?k)0L---
Address: 767 q
G�� .`� _ Company: 1 4 .—!Ihc-
City: V(`C-\ S- State: �—L Address�:g�Q ik)w 1 Qj `-A e
Zip Cade: dd( Fax: _ City: EL
Phone No. C ��' Zip Code: 3 yq��G Fax:
E-Mail: Phone No. —7-7vc— 001
Fill in fee simple Title Holder on next page(if different E-Mail: euF IJNc r` (..I)
from the Owner listed above) State or County License: C rc f q)—s(�
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.