HomeMy WebLinkAbout5270 compass coveAll 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 A venue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
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PERMIT APPLICATION FOR: C C_
PROPOSED IMPROVEMENT LOCATION:
Address: JSZ. QM
Legal Description:()m(1 P�r-� i,.�.;p yr n-�=,� In
Property Tax ID #:
Lot No.
Site Plan Name:
Project Name: Block No.
Setbacks Front Back: _ Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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SF-E 9- 1
W,F- 5
&CONSTRUCTION INFORMATION:
Addona wor to a pe Dime un er t is permit - c ec a t at Opp y;
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: $ Utilities: —Sewer _Septic Building Height:
OWNERAESSEE:
Name
Address:) �n
City: S&te:
Zip Code Fax:
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Company: 7<A agdes �, * 4
Address:92,95- 6ayA G-r
City: e;,o -G%4 State:
Zip Code: -92ft> Fax:
Phone No Z-2
E-Mail 0A fi�
State or County License C 19199049
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.