HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICA[LE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Z Permit Number:
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Building Permit Application
Planning and Development/
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Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce F134982
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: 1 CUVA a01100 Cfttt(t f! f n i & t
Legal Description: 1 al La ks J CoY
Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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CTION INFORMATIONt
wor to e e orme un ert ispermit-c ec a appy:(�jC ID Gas Tank []Gas Piping _ Shutters ❑ Windows/Doors
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Electric Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: r� S Ft. of First Floor:
Cost of Construction: $ �u V - ®o Utilities: — Sewer Septic Building Height:
OWNERAESSEE:
CONTRACTOR: ,
Name CA
Name: `
Address: ay o .fiti�,(i W.
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Company: Y Yi 11
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City: ((7Y Race, State: �[.
Zip Code:.3 411 Fax: N j N
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Address: ��
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—State:
Zip Code: 3LK151 Fax: JP-46-3-131
Phone No.
E-Mail: MI(VIDWA
Fill in fee simple Title Holder on next page (if different
E-Mail: �. iaU �QA_�(@.hCCJ
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State or County License: 0_ka1'3 (Z VZ (a
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.