HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
4 J
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.
Address:? r,rc�
Legal Description:
Property Tax ID #: - 7t) U 6) I- -- - _ Lot No.
Site Plian Name: Block No.
Project Name:
Setbacks Front
Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
A,\ �, � Y't � � k 7 C u h �f r :� ; t � C.� ►-� � }��cy ,�-�.
CON�TRLICTION INFORMATION:
ion ,
nAdditionalp�IL�VJf6l work to bLperformed under this permit - check all that.app U:
LJHVAC LJ Gas Tank
[]'Electric 0 Plumbing
Total 4q. Ft of Construction:
Cost of Construction: $ 47
s Piping
CONTRACTOR:
UShutters
❑Windows/Doors
Address: 2 41;L5 -7 ec-vt�O' v-
rinklers
City: A A- 54. X ;n r' State: FK
13Generator
Zip Cgde: t~1'Fa?�O Fax:
El
Roof
Roof pitch
SFt. of First Floor:
UtilitiestSewer Septic Building Height:
OW ER/LESSEE:
CONTRACTOR:
Name_ A re,1 ! vl
Name:
Address: 2 41;L5 -7 ec-vt�O' v-
Company: �� r� , L �',-r ''� , ti� •.�..
City: A A- 54. X ;n r' State: FK
Address: 37 &5— / cap, e- r — LY
Zip Cgde: t~1'Fa?�O Fax:
City: _ f ��'�c 6 State: �.
Phone No. 21 31- i9 C-)
Zip Code: _3 Li 7 V�� Fax:
E -Mail:
Phone No. ' L1 U q - S' 2r
Fill in fee simple Title Holder on next page (if different
E -Mail: L -J 6
from the Owner listed above)
State or County License: (' C 3& sS
�. ,ro�aa4 ui L.L11aL1 ML.LLNn la v7LJWV Vr MUre, a 11MUKUM Notice OT t:Ommencement is required.