HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 E '
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential G�
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED. IMPROVEMENT LOCATION:
Address: 1 cl; Ile
Legal Description: .-
Property Tax ID #: l v L 3 - rw Q - pOO --5' Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DEVILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Acid itional work to be neffio—r—m—e-d under MEpermit —check all apply:
0HVAC Gas Tank ❑Gas Piping In _ Shutters
Electric Plumbing ❑Sprinklers ❑ Generator
Total 5q. Ft of Construction:
Cost of Construction: $ 3 r
ERAESSEE:
S . Ft, of First Floor: _
Utilities:0 Sewer []Septic
Address: aSr t - ,,"e-1v,i I r i'ell-It
City: , t' fee -
State: A�
Zip Code: 3_J Cr VA Fax:
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
CONTRACTOR:
Name: GrL
Company:
Address:
City:
Windows/Doors
Roof Roof pitch
Building Height:
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Zip Code: _.�!y �Z Zf a Fax _.`LC
Phone No. YA- 9 i-
E-Mail: Wc) z %%r C6 yr J .+ "".
State or County License: 01C (4S l
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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