HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number:
Date:
nuituing rermut HppliCaVon
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 Residential
Phone: (772) 462-1553 Fax: (772) 462-3578 Commercial __
PEKMI I APPLIC;AI ION FOR: To Select from dropbox, click arrow at the end of line
PROPOSEL) IMPKOVEMEN I LOC;AI ION:
Address:
Legal Description:
Lot No.
Property Tax ID #: Block No.
Site Plan Name:
Project Name:
Back; _._Right Side: Left Side:
Setbacks Front
I* I A1LEL) UESCKIP I ION OF WORK:
CONSTRUCTION INFORMATION:
HVAC Gas Tank
[]Electric Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $
OWNER/LESSEE:
tnis perms — �1
[]Gas Piping
OSprinklers
e7mnsc 01 -/01 -/I -.t. 1'10/t /
apply:
_Shutters ❑ Windows/Doors
Ge nerato r
Roof Roof Pitch
Sq. Ft. of First Floor:
Utilities: Q Sewer[] Septic
Name k1111a' /0-i r lv
Address: N"LlAjLl�u'
City: 410 State: L
Zip Code:
Phone No.
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the owner listed above)
CONTRACTOR:
Building Height
Name:
Company: �►�rti1��cCCn
Cu3Tom A �c- JuS�el'K 1ti
Address: 1 lE t5 'S G�' t dG
;
Po o R..1^ 9t L. ;;c (c_ State: r�
City: a �+4 52- _ Fax
Zp Code:
Phone No. i a� 3:5- - 3
E -Mail: u S t C% i t s Cc l C c• �ti
State or County License: A C (I
required -
if
value of construction is $2500 or more, a RECORDED Notice of Commencement is
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is