HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: )2)2.-7110 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 x
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line III
PROPOSED IMPROVEMENT LOCATION: II
Address: W u it j f_)IIJ/I1A
Legal Description: DD 27 A 734E 2P-LERVE AU113FIEb
R E -P LAT L (7T z
PropertyTaxlD#: 3 32r9— !l�30IC9' 000_ i_ DOD --13 Lot No.
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
Block No.
DETAILED DESCRIPTION OF WORK: III
�} ►acs GcT� h f_0,+ef--
UT 6A -c-
CONSTRUCTION INFORMATION:
trona wor to LerTormed
_un ert ispermit-c ec a appy:
❑HVAGasank []Gas Piping Shutte
rs ❑Windows/Doors
U Ele
bing 11 Sprinklers 11 Generator Roof = Roof pitch
Total Sq. Ft of Construction: }�
Cost of Construction: $ I � C , CE)
Sof First Floor:
: _
UtilitiesSewer � Septic
Building Height:
OWNER/LESSEE:
CONTRA TOR:
NameName:
Addres : i
Company:Or
Acicim
City State:
Z' Code: Fax:
Phone No.Z % -7a - WIR-0 D
City: Pi
Fax:
Phone No. a�-
__1!
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail:
State or County License.
If value of construction is $2Soo or more, a RECORDED Notice of Commencement is required.