HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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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: CCC, Ito
Legal Description:
Property Tax ID#: 3 l 311'd UzV1_ o6U 'C) Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
Additional work to be-p—erformed under this permit–check all that appy:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
Electric _Plumbing _Sprinklers G rfdFator Roof Pitch
Total$q.Ft of Construction: Sq.'Ft. of Fir5.t floor:
Cost of Construction:$ 2 U c> d Utilities '_Sewer rr,,�Sepxjc..., Building Height:
Name u ss er Name: '1/ . r/ S
Address: f a Sy Laid Tom-- /1 Company: e,-
City: /::�_l �°f T 17 c l State: Address: SZ: !---
ZipCode: Fax: City: l/7 l n e c State:
Phone No. Zip Code: y f Gs-i Fax:
E-Mail: Phone NoU 'e�yiio'd
Fill in fee simple Title Holder on next page( if different E-Mail
from the Owner listed above) State or County License vZ FCY Z..
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.