HomeMy WebLinkAboutEM 1ALL 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) 4621578 Commercial �� Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PRO, OSE.D IMPROVEMENT LOCATION:
Address: 71-1��&( CCIm
Legal Description:
Property Tax ID #: `-fC�l : Q-i1L1Ca - Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
`. �. c�, Y. Ce t, n n5 e--,(- C1*11 , �
CONSTRUCTION INFORMATION:7
appy:
Additional work to a er arms under this permit c ec aMGasTank
HVAC ED E]Gas Piping Windows/Doors
_Shutters
Electric 11 Plumbing Sprinklers E Generator Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction. $ Utilities: Sewer L_Flj=iSeptic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name , : t Name: ` r�
Address:? 9(c rn , c.. ,� r Company: c9 l i -
r
City: — 'c e e'r State: vL Address: S� 71: f r?�, r✓ vim..
Zip Code: 3 LI 9-5- i Fax: City: v` e e r -r e 2r._1
—State;
Phone No. zip Code:3 `1 S V—) Fax: S/— /l 1-7
E -Mail: Phone No. ' q& L/— 9
Fill in fee simple Title Holder on next page ( if different E -Mail: CIJ6 , 1 r` fa P?f I ;4
from the Owner listed above) State or County License: OAC if ( 3 & f
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.