HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 4.1g. / 9 Permit Number:
J
• Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34981
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
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PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line I
I PROPOSED IMPROVEMENT LOCATION: I
Address:
Legal Description: lJ�S1%�:C�1J:�1:� ems.-a�ai�%�7�U�_��•I%/�['c
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Property / / / / I / •
Site Plan Name:
Project Name:
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Back: Right Side: Left Side:
Block No.
I DETAILED DESCRIPTION OF WORK: I
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CONSTRUCTION INFORMATION:
CONTRACTOR: _
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Additional work to
❑HVAC
me under tispermit–checka
Tank E]Gas Piping
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appy:
Shutters
Windows/Doors
Electric
— Plumbing Sprinklers
� Generator
� Roof Roof pitch
Total Sq. Ft of Construction:
Sq. Ft. of First Floor:
Fill in fee simple Title Holder on next page I if different
Cost of Construction:
$ If Doo. no Utilities: Sewer 0Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR: _
Nam n n 11
Name:
Compan
Addrefl
City: State: ft_i
Ad
Zip ode:S
City: Stater
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Phone No. ��3l –gL y'• Onto 10
Zip Code: Fax:
Phone No.
E -Mail:
Fill in fee simple Title Holder on next page I if different
E -Mail: roll,
from the Owner listed above)
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State or County License:
It value of construction is $2500 or more, a RECORDED Notice of Commencement is required.