HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLY INFP MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: t 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: (JIPU d
Legal Description:
B(L t
Property Tax ID #: & 1 -b 11-0034 -000 -3 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
V kk U J(,t : T*IsA I new 3 +n i A 5 ErR L2 wy .Ns-Izo
u,�kh 10 Kw tiea
CONSTRUCTION INFORMATION: _
aCwortoLorme under this permit -check a _apply:
a Windows/Doors
Gas Tank [_]Gas Piping Shutters
Electric E] Plumbing L 1Sprinklers Generator F]Roof
Total Sq. Ft of Construction: SgFt. of First Floor:
Cost of Construction: $ qu c) Utilities: lSewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
Name:
Address: R letns= tX
a
Company: Boyllaf9
Jhc
City: State:
Zip Code: 34q5 ( Fax: AJI/j
Phone No.?'71-5-11-1 55
Address:510 6 ATltM afUc !9
City: rb(-b f (e c& State: R_
Zip Code: .34451 Fax: -712--4&/F-373i
Phone No.-`(g-- l4tof -41 k i
E-Mail: N
A
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail:
State or County Licen e: C.ikW M3
if value of construction is $2500 or more, a RECORDED Notice of Commencement is required.