HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1 Date: I f t Permit Number: t�04, �j n
_ 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 v
PERMIT APPLICATION FOR:
PRIP�SED 1NiP'ROUEMEN LO ATIC•7 :
Address:
Legal Description:
Property Tax ID#: 3��2 (60 5 02 2 3 000 P Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED RESCRIPT G1 OF ORK:
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C+ ST' UCT O NFORMAT!• N:
Additional work to be pertormed under this permit—check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ �� Utilities: —Sewer —Septic Building Height:
0 NER/LE=-SASE ; �ONTRA� C+3R:
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Corripany: =
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Zip"Code:` Fax'. Cl "
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1 - �27 Fax:
Pho 7Z=ne No: � � Zip Code. `t i��i
E-Mail: Phone No`771` ,7_xif C �a�✓
Fill'in fee simple Title Holder on next page(if different E-Mail11
from the Owner listed above) State or County License
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.