HomeMy WebLinkAbout Permit Application 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.
Roof pitch
X
393 SEAHORSE TER FORT PIERCE, FL. 34982
TROPICAL ISLES (OR 2786-2163) UNIT J-20
3410-508-0276-000-2
GALLIPEAU RE-ROOF
1643
17,840
RICHARD GALLIPEAU LARRY NEESE, LLC
393 SEAHORSE TER LARRY NEESE, LLC
FORT PIERCE 506 S MARKET AVE
3498 FORT PIERCE FL.
772-521-2163 34982 772-361-6581
772-361-6580
LARRYNEESE@LARRYNEESE.COM
CCC1330608
5/12
FL.
Roof
REMOVE AND REPLACE SHINGLES AND ROOF COVERING ON EXISTING ROOF.
Owens Corning : NOA No.: 16-0425.01
Tri-Built : FL16048-R6
15 May 18 15 May 18