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Building Permit Application
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �_)^C 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: PRC�3POSED IE ENT LOCATCaN: %ddress:Lo,w 2 nm.r.Ene, 5iV1 Legal Description: Property Tax ID#: O Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED I3EMSCRIPTI®N QF WORK: CONSTRUCTION INF©RM4TION: Additional worlZto be pertormed under this permit–check all that appy: Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Electric - Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $c _ Utilities: —Sewer ._Septic Building Height: OW ?R��SEE: e CONTRACTOR: Na ',_..� Addres � � -� ,dame: CoCnjany: City: State• Address: Zip Code: Fax: City: State: Phone No.119 a- ` — Zip Code: Fax: E-Mail: one No Fill in. "simppletle Holder on neA pag 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.