HomeMy WebLinkAboutkirby loop 1ALL 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 ti..
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:
Legal Description:
Property Tax ID #; '_-2L4a0 4c'o - q Lot No.
Site Plan Name: Block No.
Project Name;
Setbacks Front Back: Right Side; left Side:
DETAILED DESCRIPTION OF WORK:
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CONSTRUCTION INFORMATION:
itiona wor to a er orme under this permit - c ec a appy:
HVAC 13 Gas Tank 0Gas Piping Shutters Windows/Doors
1-1 Electric ® Plumbing Sprinklers E]Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction;
S . Ft. of First Floor:
Cost of Construction: $ cq_� Utilities:] Sewer ®Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name, . 0-c Name: io
Address: '�fv. s -4&4a Company: _ �-
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City: :' t r r e_ State: Address:' -7
Zip C de: Fax- City: = ere -c -State: A::`_
Phonel No. Zip Code: Fax: Y- ((a '7
E -Mail: Phone No. Z S8 -
Fill
8Fill in fee simple Title Holder on next page (if different E -Mail: CA36, r
from the Owner listed above) State or County License: Ckc 3
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.