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)452-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 0-5,�, i & P.
Legal Description: 13
Property Tax Ili#: r ' { o Lot No. C�
Site Plan Name: Block No_
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additional work to orme under this permit—c ee a M apply:
C_1HVAC f]Gas Tank Gas Piping _Shutters E]Windows/Doors
Electric ® Plumbing Sprinklers FI Generator Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
el
Cost of Construction:$ 1 .5 Utilities:0 Sewer OSeptic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name bfm G111 Name: _ Q
Address: T l-1T 1P..s a.� Company:
City; 1/ ) )01t��✓ State: l"r! Address: � ��-�'' �h Y Z
Zip Code: b F Fax: City:L State:
Phone No. � 1 .mod�C r1_ Zip Code: L'`90k" Fax:
E-Mail: Phone No. ` -777- '/D
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.