HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: j �1� I 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 J
PERMITTYPE:
PROPOSED IMPROVEMENT LOCATION
Address:_,a�)L'LICYIt„..,..,--
Property Tax 1D #: 3M - _11 � �q- (of) -' Lot No.
Site Plan Name: Block No. rf
Project Name:
CONTRACTOR:
Name /` I1�+s�ii�l' �)rA ��7/l17 l _�..
Address:_�i�p�� M_ _ �'
Name:
Company: l`I v1 a
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City:`,_ State. .l_
Zip Code: r7, Fax:
Address: L1;
City:
Stater
Phone No. �%, ��' .�(✓� - : 1
Zip Code: -2 Ll 1)SS 4
Fax: =-
E-Mail:
Phone No
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Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail
State or County License
If value of construction is 52500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.