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 JPhone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR:To Select from dropbox,click arrow at the end of line
PROPOSED I MPROVEMENT LOCATION:"
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Address:Iti/I r1~bl:C,t~~Y\(DAd
Legal Description:\~"t.Y'~C\{'h l\{\\'~C)..~(~r.1\\\~1 f)L-O\II AQ~3~l{)l~
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Property Tax 10 #:34lq ~510-005$A-OOO-{P Lot No.
Site Plan Name:Block No.
Project Name:
Setbacks Front Back:Right Side:Left Side:
I DETAILED DESCRIPTION OF WORK:',
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CONSTRUCTION INFORMATION:"
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Additional work to br prtormed under this permit -check all U apply:oWindows/DoorsDHVAC_Gas Tank DGas Piping _Shutters
DElectric ~mbing 0Sprinklers DGenerator DRoof D Roofpitch
Total Sq.Ft of Construction:S8 of First Floor:
Cost of Construction:$Utilities:_Sewer D Septic Building Height:
OWN~RILESSEE:.\.,
CONTRACTOR:~--:-,-',-'.,...,'-'-.-.r ,
Name \.1(OWeve..v I'nvtt LLt-Name:\}){\v'f('\-:'\()C\let h'\O
Address:c':104'l n C\((~*ICOJ-I Company:'m~~hl\l~l1irt('ltJQl~Sl'yt ~
City:r-t ~\~re State:fL Address:Jldl"9 j~E'«(YW2'<5f-
Zip Code:3494 q Fax:City:~5L State:r~
Phone No.Zip Code:Jl/96~Fax:
E-Mail:Phone No.1i:J..'3"3L '1:27iL
Fill in fee simple Title Holder on next page (if different E-Mail:\1teQl~jtnblrt q w{)tI~:2'l1L ~q ma.d •t //YJ1
from the Owner listed above)State or County License:
If value of construction.is $2500 or more,a RECORDEDNotice of Commencement is required.