HomeMy WebLinkAboutbuilding permit ALL APPLICABLE{I� FO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 2''L Permit Number:
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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 X
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PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: FiOW �-_VNIf\Jw,jOy} i}><- ►r"t. ciC �A'_
Legal Description: ' s�k� qG 6- Oy- �5 ' T' Q S 1� "� QF �� ." IN OF
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Property Tax ID#: 3L{O (A13 _ ( 5 - O(M -'S Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
iti a worko to e er rme under this permit-check a apply:
HVAC Gas Tank ❑Gas Piping Shutters Windows/Doors
Electric ❑ Plumbing Sprinklers L1 Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ �, "► V Utilities:cnSewer Septic Building Height:
OWN ER/LESSEE: CONTRACTOR:
Name Y t11 tI-\%- `�. iL t� Name: r.. . y -L
w P 1rJ1' �'� ifi � �
Address: -L\1 kk'6 1 Company: �uI� JL' �j Lim
City:�smQ N\i 1A,-)4C� State:_�k Address: 1 OU z 1N
Zip Code: D`�'L3- L Fax: ' City: Y State: Ft
Phone No. o1 )1. Y)3 • �A6(0 3 Zip Code: 1)i- Fax:
E-Mail: Phone No. 30S ( iVA - 'IS` %_
Fill in fee simple Title Holder on next page ( if different E-Mail: I �i1ti3L���11Z C��v1+q ►�. C'd+f✓1
from the Owner listed above) State or County License:
If value of construction is$2500 or more, a RECORDED Notice of Commencement is required.