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
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR:
Address: 41'�(
Legal Description:
Property Tax ID #:
Site Plan Name: _
Project Name: _
Setbacks Front
Back: Right Side: Left Side:
Lot No._
Block No.
I DETAILED DESCRIPTION OF WORK: I
i
CONSTRUCTION INFORMATION:
nalworkto be performed under this
permit– check all
that apply:
Name: IS S
3it
� echanical _Gas Tank
_Gas Piping
_Shutters
_windows/Doors
Electric _ Plumbing
_ Sprinklers
_ Generator
_ Roof
Total Sq. Ft of Construction:
Sq.
Ft. of First Floor:
Cost of Construction: $ tJ3
Utilities:
—Sewer _Septic
Building Height:
OWNER/LESSEE)
CONT ACTOR:
Name XIL.A. 11r
Name: IS S
Addre
Company:
City: a State•.
Zip Code: Fax:
Phone No.
Addrs: " u
City: o� State:
Zip Code: Fax:
Phone N
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Ma' Z w -G
State or County License:
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.