HomeMy WebLinkAboutBuilding Permit Application page 1ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
CC)U NTY
F E 0 R 1 o q
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: To Select from dropbox, click arrow at the end of line (ke r ocrIP
PROPOSED IMPROVEMENT LOCATION:
Address: l SLY
S rE 5: %,IcL L ti
o. t S
L
FL
Legal Description:
R%V f -C PIL-a.
9
Property Tax ID #: y t Lot No. C1
Site Plan Name: Block No. (,� 2 -
Project
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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CONSTRUCTION INFORMATION:
Additional work to ee orme un er t is permit - c ec a appy:
HVAC ❑] Gas Tank ❑Gas Piping Windows Doors
nn Shutters a
L�J Electric ❑ Plumbing OSprinklers ❑ Generator ® Roof a la Roof pitch
Total Sq. Ft of Construction: _2j i (,- f; 5 . Ft. of First Floor:
Cost of Construction: $ ,. C)Q , iD3 Utilities: Sewer ❑ Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name
Address: 611 S e Vc� '}-
City. bogle_ State: FL_
Zip Code: 34 el 9a 3 Fax: 'l -156 CC) c 7
Phone No.
E-Maildn+ cdc'-Z'Ad 0 St'v,44 �t+StG�r� LhnC, tCYY1
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: P dl�f{C 1
Company:. r, Gtng-cd C'rA'-%An'C *fA 5 (_''fVv
Address:l S
City: mv1 State: FL -
Zip Code: 2aatia4 Fax: S-71 --1i �jjQ UJc7�
Phone No. -1 p -3
E -Mail: t m LJ- ont'I&Pick Cts'
State or County License: F Ot' c tin
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.