HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ____________________ 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:
PROPOSED IMPROVEMENT LOCATION:
Address: __________________________________________________________________________________________
Legal Description: ___________________________________________________________________________________
__________________________________________________________________________________________________
Property Tax ID #: _________________________________________________________________ Lot No.__________
Site Plan Name: __________________________________________________________________ Block No. _______
Project Name: ______________________________________________________________________________________
Setbacks Front__________ Back: _________ Right Side: _________ Left Side: ________
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit – check all that apply:
__ HVAC __ Gas Tank __ Gas Piping __ Shutters ___ Windows/Doors
__ Electric __ Plumbing __ Sprinklers __ Generator ___ Roof
Total Sq. Ft of Construction: ___________________ Sq. Ft. of First Floor: _________________________
Cost of Construction: $ _____________________ Utilities: __ Sewer __ Septic Building Height: __________
OWNER/LESSEE: CONTRACTOR:
Name__________________________________________
Address:________________________________________
City: _________________________________ State: ___
Zip Code: ______________ Fax:____________________
Phone No._______________________________________
E-Mail:_________________________________________
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: __________________________________________
Company: _______________________________________
Address: ________________________________________
City: ______________________________ State:____
Zip Code: ________________ Fax: __________________
Phone No. _______________________________________
E-Mail: __________________________________________
State or County License: ____________________________
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
Roof pitch
May 1, 2019
X
2859 Divine Rd Fort Pierce, FL 34981
WHITE CITY S/D 05 36 40 W 250 FTOF E 1293.4 FT OF LOT 68-LESS S 165 FT- ALSO DESC AS W 250 FT
OFNW 1/4 OF NE 1/4 OF NE 1/4-LESS S 358.60 FT AND LESS RD RS/W- (1.45 AC) (MAP 34/05N) (OR 1023-853)
3403-502-0127-000-3
Clark Re-Roof ( Building # )
John Clark LARRY NEESE
2859 Divine Rd LARRY NEESE, LLC
Fort Pierce 3401 S. US HWY 1
34981 FORT PIERCE FL.
(954) 292-1566 34982 772-361-6581
772-361-6580
larryneeseroofing@gmail.com
CCC1330608
3/12
FL
Roof
Remove and replace existing roof covering (building # )
Owens Corning Shingle : NOA NO : 16-0425.01
Tri-Built - FL16048-R6