HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE IF MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Z! �j9 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
PROPOSFD IMPROVEMENT LOCATION
N�SW711L•�U�'lL�,���li��l'LII+1lr
Property Tax I D #:
Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side: Left Side:
k;DETAILED DESCRIPTION OF WORK:
�ilt� dor LikQ : -f*S-f acl I)# hJ �#AV10x I q Stele a-5 -fon A
split &45MM W I-iln 10 kW heat .
Lot No.
Block No.
CONSTRUCTION INFORMATION:
CONTRACTOR:
Name
Addres:r_� f 1
City: 1 � Stater
Zip Code:3A6 i Fax:
Phone No. - 2--�i228
Name: Michul lb
Additional work to e e Orme under
1:1
t—checkispermit
Gas Piping
a
appy:
Shutters
Q windows/Doors
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E -Mail: �p�Q Q L
HVAC
Gas Tank
_
DElectric 0 Plumbing
Sprinklers
Generator
Roof
Total Sq. Ft of Construction:
Ft
ScFt. of First Floor:
Cost of Construction: $ 4060.00
Utilities.
RSeptic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
Addres:r_� f 1
City: 1 � Stater
Zip Code:3A6 i Fax:
Phone No. - 2--�i228
Name: Michul lb
Company: AlY Ii'1 dW
Address,::5110A5 p TaY, NCI
City: �Vl L C � ze� Stater
zip Code: 3LASI Fax: `Yt1'NG6'3'13l
Phone No. TV-1A(tl- 1;A l
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
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E -Mail: �p�Q Q L
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-
State or Co nu ty License: I U(0,11 1.112 (0
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.