HomeMy WebLinkAboutbuilding permit ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
i
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
PROPOSED IMPROVEMENT LOCATION:
Address: 'q u
Legal Description: Poe i�:j no
Property Tax ID#: L r 5Q2 00 - J 000 ' Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
1OL ,VV�-�,.V\+- o4 50 �at e leck c Lyle &L4�e
CONSTRUCTION INFORMATION:
Additional work to orme under t is permit—checka apply:
HVAC f]Gas Tank Gas Piping _Shutters Q Windows/Doors
Electric Is Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ Utilities:OSewer Useptic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name -1 EA Ih, Name: Ci 3wpz,
Address: 61 91 a )z Dr- Company:
City: L. State._ Address 1,-2 q A;L4-; C o
Zip Code: q 51 Fax: City: Lf k cA State: FL
Phone No. J T -5 3? 55il Zip Code: > q _ Fax:
E-Mail: Phone No. ~�hex -7 00
Fill in fee simple Title Holder on next page(if different E-Mail: f { WTI i
from the Owner listed above) State or County License: M V C-Ty
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.