HomeMy WebLinkAboutPermit Application Pg1 ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ____________________ 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:
PROPOSED IMPROVEMENT LOCATION:
Address: __________________________________________________________________________________________
Legal Description: ___________________________________________________________________________________
__________________________________________________________________________________________________
Property Tax ID #: _________________________________________________________________ Lot No.__________
Site Plan Name: __________________________________________________________________ Block No. _______
Project Name: ______________________________________________________________________________________
Setbacks Front__________ Back: _________ Right Side: _________ Left Side: ________
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit – check all that apply:
__ HVAC __ Gas Tank __ Gas Piping __ Shutters ___ Windows/Doors
__ Electric __ Plumbing __ Sprinklers __ Generator ___ Roof
Total Sq. Ft of Construction: ___________________ Sq. Ft. of First Floor: _________________________
Cost of Construction: $ _____________________ Utilities: __ Sewer __ Septic Building Height: __________
OWNER/LESSEE: CONTRACTOR:
Name__________________________________________
Address:________________________________________
City: _________________________________ State: ___
Zip Code: ______________ Fax:____________________
Phone No._______________________________________
E-Mail:_________________________________________
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: __________________________________________
Company: _______________________________________
Address: ________________________________________
City: ______________________________ State:____
Zip Code: ________________ Fax: __________________
Phone No. _______________________________________
E-Mail: __________________________________________
State or County License: ____________________________
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
Larry Neese
Larry Neese Roofing, LLC
506 S. Market Ave.
Fort Pierce FL
34982 772-361-6581
772-361-6580
larry@LNroof.com
FL CCC1330608
X
7709 White Egret LN Port Saint Lucie, FL. 34952
EAGLE`S RETREAT AT SAVANNA CLUB PHASE 2 (PB 43-21) BLK 63 LOT 19 (OR 3628-13)
3424-702-0180-000-1 19
63
Removing existing shingle roof covering and installing new Owens Corning roof covering
Pitch 3 :12
1786 1786
9,350
James Tirabassi / Mary Tirabassi
8535 39th Ave
Kenosha
53142
262-358-1271
tirabassit@bellsouth.net
WI
Roof