HomeMy WebLinkAboutfogg 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
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: ,�, � {
Legal Description:
Property Tax ID #: q '� --
Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
I -
Un
I CONSTRUCTION INFORMATION: I
iaiincu unuci L1 ua ldcI III3L-LI
Gas Tan
�HVAC k Gas pi
n
ping
11 Electric 0 Plumbing []Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ L1Z. O
apply:
Shutters
OGenerator
S . Ft. of First Floor: _
Utilities:11Sewer 0Septic
❑ Windows/Doors
E]Roof Roof pitch
Building Height:
OWN ER/LESSEE:
CONTRACTOR:
Name
Name:
e7 ,
Address: t- U t ��
Company: Wo
: f r r
City: Cf[ Stater
Address:
Zip Code: ZS Fax:
City:
State: a
Phone No.
Zip Code: 3 �`[Ci cS
Fax:
E-Mail:
Phone No. LO
--
Fill in fee simple Title Holder on next page ( if different
E-Mail:
C' C01,IJ} w
from the Owner listed above)
State or County License:
Ii s?«oo ur more, a ncuumucu nonce oT Lommencement is requireal.
'J