HomeMy WebLinkAboutpermit applicatioALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date;
Permit Number:
Building Permit Application
Planning and Development Services
Building orad Code Regulation Division
2300 Virginia Avenue, Fort Fierce FL 34982
Phone: -772} 462-1553 l=ax: (772) 462-1578
Commercial
Residential
PERMIT APPLICATION FOR: To Select from drpbx, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address:
7,2;T1 00201 111
Legal Description:
Property Tax I .
Site Plan Name. -
Project Name
Setbacks f=ront
�) OIS841
Back:
Right Side; Left Side:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Iditional wor
I� HVAC
Electric
4ti
Lot N0._ 6
Block No.
to be erforrrzed under this permit—check all that appy:
Gas Tank Gas Piping � Shutters � Windows/Doors
�y
�t.PlumbingSprinklers � Generator � Roof Roof pitch
Total Sq. Ft of Construction;
Cyst of Construction: $
Sq. Ft. of First Floor:
Utilities: Sewer Septi c
Building Height:
W N E CESS E E: CONTRACTOR:
r.
Na -
r
city State 4Address: L
r/\., It- Stage:
ak
Zip cle. Fax
Phone No.. � � , � � � Zip Code: _
'77
E -Mail.
Phone No. 77CU -
Fill in fee simple ie Title Holder on next page if different E -M a11:
from the Owner listed above) Mate or County License.
if value of construction is $2500 or more, a RECORDED Notice of Commencement is required.