HomeMy WebLinkAboutBuilding Permit ApplicationALL l PPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
Planning and Development Services
BuilUing and Code Regulation Division
230¢ 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
PR POSED IMPROVEMENT LOCATION:
Addr6ss:
Legal iDescription:
Property Tax ID tela 1 4 - am - wo - uc,_'s ,
Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DET ILED DESCRIPTION OF WORK:
ECONISTRUCTION INFORMATION:
Additional work to 5Tberformed under tis uermit - c ec all t at ann tir
HVAC L I Gas Tank
Electric Q Plumbing
Total 5q. Ft of Construction:
Cost of Construction: $
Sas Piping Li Shutters windows/Doors
Sprinklers []Generator Roof Roof pitch
SFt. of First Floor:
UtilitiestSewer Eleptic Building Height:
OWER/LESSEE:
CONTRACTOR:
Nam¢°vfwtl `i.i
Name: c 0.zp.
Add4ss: (004 ec
Company:
4.r
City: I-_- ` L7( " C"State:'
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Address: 7%���,�(et`
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Zip Code: 3401'-/5' _ Fax:
City:�= �- . (,' e P
4 State: A�
Phono No.
Zip Code. -344 7
Fax: q
E -Moil:
Phone No.' 1-d LP Li
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Fill in Ifee simple Title Holder on next page ( if different
E -Mail: �-v U
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from ;the owner listed above)
State or County License:
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...-._r •.. •,•, ��• ����•• !' ���.., �! !!�«, d �acwRur� ��oz��e yr wmmencement is requ�rea.