HomeMy WebLinkAboutBuilding Permit application-�L. rrLR.ALE 1 FO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3 U ,
92908WF Permit Number:
Building Permit Application
Planning and Development Services
Building and Cade 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: Niueh
Legal Description:ILVut�t5f
Property Tax 1D #.-
Site
:Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side:
DETAILED DESCRIPTION OF WORK:
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INFORMATION:
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Left Side:
Lot No.
Block No.
y-=JnvA� L—iGasTank "Gas Piping
"Shutters
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(_) WindowsJDaors
Electric Plumbing Sprinklers
Q Generator
Roof
Total Sq. Ft of Construction:
,r,-�
Cost of Construction: $ "IUVU•ul/ Utilities:]
S
Ft.
of First Floor:
Sewer 0Septic
Building Height:
OWNERf LESSEE:
CONTRACTOR:
Address: S[} V L �/j .�A�
Name:
i
City:rlQV(Q State:_
Company: (
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Zip Code: 2r�LI4 Fax:
City: rUr&--
Phone No._ (!' q1%- rpp Lf ';k.
Mail:
State: r
Zip Code:. f 5 } Fax: -71.,1-- 4&4j 373i
Phone No. Z C}+
Fill in fee simple Title Holder on next page ( if different
E -Mail: --� _
from the Owner listed above)
O. On rn
State or County Licen e:
CAC I $ IS 13
H value of construction is Sz5 or more, a RECORDED Notice of
Commencement is required.