HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICBE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
i
Building Permit Application
Planning and development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 452-1553 Fax: (772) 462-1578 Commercial Residential-
esidential_PERMIT
PERMITAPPLICATION FOR:
PROPOSED INPROERir'I NT LOCATION:
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Address: I+fJl!O7:1--f 3 - —�z
Legal Description:
Property Tax ID #: -_1 _! S 2- 907 --0(J t Lot No.
Site Plan Name: Block No. _
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
J CA 1 LIE i` C( r/
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CONSTRUCTION INFORMATION:
Additional work to be performed un er t is permit- check all that appy:
ZMechanical Gas Tank Gas Piping _Shutters Windows/Doors
v Electric _ Plumbing _ Sprinklers _ Generator Roof Pitch I
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cast of Construction: $ Utilities: _ Sewer _ Septic Building Height-
OWNER/LESSEE,: CONTRACTOR:
Name� '- yX ) 11AName:
Address: —Srer/ l✓t Company: ez
City: i7 f -P I/State:0Address:_'" r Q
Zip Code: Fax: City: State:
it Phone No. - Zip Code: 9 F
E -Mail: Phone No_7 2 - (k0 9 — 2a (.r- `Z,
Fi!l in fee simple Title Holder on next page lig different E -Mail fe((
from the Owner listed above) State or County License_ -A 1 _7 0 Z42
if value of construction is 2500 or more, a RECORDED Notice of Commencement is required_