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HomeMy WebLinkAboutCCF_000359ALL 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) 462-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION: Addr L2 Legal Description: 5 - ` " ` 1 Property Tax ID #: 33 S r `,� i Oyv`"�' Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: W I I t CA -firm CONSTRUCTION INFORMATION: itna wor to orme un er t is permit — c ec a appy: HVAC ❑Gas Shutters Q Windows/Doors _ Gas Tank Piping _ Roof Roof pitch Electric Plumbing Sprinklers Generator Total Sq. Ft of Construction:G� S . Ft. of First Floor: Cost of Construction: $ Utilities: Sewer Septic Building Height: OWNER/LESSEE: Name CONTRAC I UK: Name: Address: UCompany: Ill 1 l 1 4 k JV I Il_\ LSM i i I i C_ I � City: CI State: Address; D Zip Code: ,_jMZ� Fax: City: �J (C state: Phone No. 3rC, ' S o1� — O Zip Code: Fax: E -Mail: Phone No. Fill in fee simple Title Holder on next page ( if different E -Mail: from the Owner listed above) State or County License:( :2"t�^� o S If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.