HomeMy WebLinkAboutscan121925923All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1���� 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 TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: 5W5 Ornnac Ayrnar
Property Tax ID #: Z _ l — O — q Lot No.
Site Plan Name: j Block No.
Project Name: � �t tiq
DETAILED DESCRIPTION OF WORK:
M
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit- check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters — Windows/Doors
_ Electric Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ U00. 00 Utilities: —Sewer —Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name: - _ , _J
Name
Address: ffAn
Company: ,
Addr _
City:
City: Y_ vicrce State:
Zip Code: 4 Fax:
No.
mState:Phone
Zip Code: Fax:7-1Z_� �'! ig
Phone No '-)-11 .`5q5 � Iq 0
g
E-Mail:1 i MO' �rQ CaSj, at
Fill in fee simple Title Holder on next page ( if different
E-Mail
from the Owner listed above)
State or County License L42
if value of construction is $2500 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.