HomeMy WebLinkAboutBUILDING PERMIT All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTE D
Date: n Permit umber:
3
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:
PROPOSED INPROV WENT LOCATION: ;
Address: {
Legal Description:
Property Tax ID#: - Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Sid :
[DE�T=AILEDSCRIPTION OF WORK: -----r
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ONSTRUCTION IN=ORMATION:
tiona wor to a m n t is permit-c ec a t at app y;
„Mechanical „Gas Tank Gas Piping _Shutters Windows/Doors
_Electric _Plumbing _Sprinklers Generator —Roof _ Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floo :
Cost of Construction:$ Utilities: —Sewer _ eptic Building Height:
OWNER/LESSEE: Co
Name i f `_ `" Name; +._Address:_ QQ (� ¢ Com anP yiC S y,. aCity: I Y State; Address: �26�fkZip Code: Fax: City; �r-D4G
State- k
Phone No. Zip Code: 3z! �-
• Fax:
E-Mail: ► r Phone Nod/- i
Fill in fee simple Title Holder on next pa e i di rent '
B I E-
Ma'it �
ffiom the Owner listed above) State or County License !$r✓$ QQ
If value of construction Is 2500 or more,a RECORDED Notice of Commencement is re uired.