HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 2_l�� 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 �II
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description:
PropertyTaxlD#: Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back:. Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: 1
)w5r t.0 Hein Lennox 4 JOV1 See,2 S'i tt1 C SLiS M U1lh�
CONSTRUCTION INFORMATION:
HVAC Gas Tank []Gas Piping
I� Shutters
windows/Doors
Electric 0 Plumbing Sprinklers
U Generator
Roof
Total Sq. Ft of Construction:
Cost of Construction: $ �500 , b0
Sq.
of First Floor:
Utilities:) _1Sewer []Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
Name: i
Address: )
nn{�--
Company: &V Q-1A-i�,,,
i/ce�'�'� gg
UtMI IR i Hpli
1i1 .
City: � Iefc& Stater
Zip Code: 3LJq64 Fax
Phone No.
i5
Address:510 EM fk-,L-
City: Refs&
Zip Code: -S0 `5J
Phone No.— (1- 4Ral-4I4-1
State: R-
Fax:�7�-4& -373.1
E-Mail: �
Fill in fee simple Title Holder on next page I if different
from the Owner listed above)
E-Mail:�AVI 90A & kulhQfL
0-1) Al
State or County License:
%/1i.' l3l,3I$
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.