HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETER 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: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT
VEMENT LOCAN
_ TIO :
Address: S 5) V 'r J P gg I
Legal Description: ipO') L-;� 8 `'A +Ke cefive'
Property Tax ID ##: �3 3.2I % o / `02d Y `0®0 ' / Lot No. � 6. 17 -71
Site Plan Name:
Project Name:
Setbacks Front Back
DETAILED DESCRIPTION OF WORK:
Right Side: Left Side:
Block No.
CONSTRUCTION INFORMATION:
A itionaT-work to e e Orme un er t ts perm it - c ec a In
app y:� Gas Tank -Gas Piping Shutters � Windows/Doors
Electric ® Plumbing Sprinklers 1:1 Generator Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ Qs�)
S. of f=irst Floor:
Utilities:11Sewer OSeptic Building Height:
OWNERAESSEE:
Name C1lG'��O, �€�itlU1vtel El
Address:
City: +A1C 1,0,0 State: 0
Zip Code: Fax:
Phone No. _�Go - 91v- COI
E -Mail:
Fill in fee simple Title Folder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name: AW S -1-0y pw 1D --I
Company:t,�P�sLi 'i -g-AIC,
Address: Gt2q DRjcQPie 411�
City: QV Z� S+ L e State: FL
Zip Code: 3 Y9 e Fax:
Phone No.
E -Mail: etA P_0 -%W(\C [J Liakoo- e-jo w\
State or County License: CFC- I L(a1�? 0 9 q
It value of construction is $2500 or more, a RECORDED Notice of Commencement is required.