HomeMy WebLinkAboutbuilding permitALL APPLICABLE
yy INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 'll tl (q 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:5 Ukm
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31iQ5)
Legal Description: i1�
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Property Tax ID #: 131 A - 100 - con - nL)Q Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back:. Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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STRUC rION``INFORMATION:
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a wor to e e orme un erY ispermrt-c ec a apply:
VAC LiGasTank ❑Gas Piping _Shutters �WindowsfDoors
Electric Q Plumbing Sprinklers ElGenerator Roof
Total Sq. Ft of Construction,:' n S Ft. Of First Floor:
Cost of Construction: $ "'Tvo• oo Utilities: Sewer Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name J0
Name:
Address: 5 q fy�(i (af'1
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n� /�, ��g04614
Company: SD16(Q rit U)lrX
City: 61t {71wp-, State:
Zip Code: 34o6I Fax:
Phone NoX(00 - W 3-(an I
Addre!ss�:5)(d A"�(,tn�1'rkn. �PJ{
City: YU�U fitPlGP. State:
Zip Code: 5 1 Fax: -77A-- 4&0- 73 7
PhoneNo.T19--
E-Mail:
Fill in fee simple Title Holder on next page ( if different
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State or County Ucen e: CihC.I$ I I
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.