HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I Permit Number:
Building Permit Application
Planning and Development services
Building and Code Regulation Division /
1300 Virginia Avenue, Fort Pierce FL 34982 ,V//
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: I
Address:�1, 1.:j1A
Legal Description:
Property Tax ID #:
Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side: Left Side:
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK:
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CONSTRUCTION INFORMATION:'
Adclit.Whal work to be Derformed under this permit —check a app y -
HVAC Gas Tank ❑Gas Piping _ Shutters ❑ Windows/Doors
Electric 0 Plumbing Sprinklers 1:1 Generator E]Roof
Total Sq. Ft of Construction: ScFt. of First Floor:
Cost of Construction: $ 3900.00 Utilities. Ft
n Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Nftllc flName:
Address �h LAk". B(4.
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Company: (
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City: State:A/
Zip Code: 34q 1 Fax:'N
Phone No. It -"a- 0.152.1
Address: X10& Ar TLUOICIP. Ne6W 4440L,
City: G r'I P lf,,fc2.
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Zip Code: .1-11
Phone No. L {�- LKC 1 -44
State: Ft"
Fax:���— fr-3137
41
E -Mail: od 116
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E -Mail: bo
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State or Co my License:
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If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.