HomeMy WebLinkAboutroyal 1ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
s
Building Permit Application
Planoing 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: �'` i � t_ c� tti c � el �s
Legal Description:
Property Tax ID #: -33 d-\ c-) - t - -7 Lot No.
Site Pion Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
CONgTRUCTION INFORMATION:
Additional work toe er-tormed under this permit -check all t= appy:
HVAC Gas Tank ❑Gas Piping _ Shutters Windows/Doors
IlElectric El Plumbing Sprinklers 1:1 Generator h Roof Roof pitch
Total Sq. Ft of Construction: S. Ft. of First Floor:
Cost of Construction: $ t f u Utilities: Sewer []Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name`
Name:
, r,
Address: `4 Q` '-
Company: o
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City: �c - State:
Address:
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Zip Code: 3q 5 369 Fax:
City: )4
State: 0-17Z
Phone No.36:E ` 7S i - _ 91a �j'
Zip Code: 3 b�4
Fax: H(I —[/.,Z 7
E -Mail:
Phone No. '
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Fill in fee simple Title Holder on next page ( if different
E -Mail: (A) ,. C-aYKc.�
from the Owner listed above)
State or County License: G_viT 0_62 f
IT value or consicrucuan is :�zbuu or more, a RECORDED Notice of Commencement is required.