HomeMy WebLinkAboutBUILDING PERMIT ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 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--1579 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 4 pw1 la"_
1� i
Legal Description: � t ` Q� `"�� � ce, L! r ! t
Property Tax ID#: W� ✓ 11 M GC[ 0 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILFED DESCRIPTION OF WORK:
T
STRUCTION INFORMATION;
lona wor to be pertormed under this permit—check all th apply:
❑HVAC ILJ� Gas Tank []Gas Piping ILJI Shutters ❑,Windows/Doors
❑Electric Plumbing ❑Sprinklers ❑Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction:$ l r Utilities:Sewer❑Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name g h Name: iJ`a'P vaI'`a'--
Address: �1 U Company: �� e.
City: � }ul '- .� ,�'-z� State: Address: Q &L r k
State: RL
Phone No. ,1 1 Zip Code: `{Q Fax:
E-Mail: Phone No. �14
2"T l —OC (�
Fill in fee simple Title Holder on next page ( if different E-Mail: QJ,q _ kA 1'V\C 00,
from the Owner listed above) State or County License: 1 �
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.