HomeMy WebLinkAboutklepper 1ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 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 I, -
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PR[QPOSED IMPROVEMENT LOCATION:
Address: ....) '? '--j ), G-C
Legal Description:
Property Tax ID #: - kjy) , Lz> 1, ooc> _ •� Site Plan Name:
Project Name:
Setbacks Front, Back: Right Side: Left Side:
DETygILED DESCRIPTION OF WORK:
i
Z0I4STRUCTION INFORMATION:
itionawor to e e orme un er t .
Lot No.
Block No.
1 `ty
. are. je
permit — c I I(:c a I I I app Y:
1 HVAC Gas Tank ❑Gas Piping _ Shutters Windows/Doors
OElectric 0 Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S . Ft. of First Floor:
Cost of Construction: $ j�l `j Utilities:11Sewer 0Septic Building Height:
OWI ER/LESSEE: CONTRACTOR:
Name 4 %,, C <, Name:
Address--?
Company: L t 6bYi�.� , ,
City: J� • �- State: Address:
Zip Cdde• �. L
Fax:
City: State: �
Phone No. Zip Code: �i Fax: -� r
E-Mail: Phone No. L( L(-
Fill in fee simple Title Holder on next page ( if different E-Mail:
from the Owner listed above) State or County License: G L } 3 6;.1E�-
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.