HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST HE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 41ulw Permit Number:
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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: $05 (AXt 41-ltrCt k- 33 Q
1eef
Legal Description: "fl�lrlr►_, M 51hNasal LI}t 555
,
Property Tax ID #: 1315-50,-0131-006A Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETA#LED IiESCRIPTION OF WORK:
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�:Ilce; T,SW( 3.5 -fonle, SES L.evtnDu lrt� Sirai CGO
biit., t KUJ Vtat •
CONSTRUCTION INFORMATION:
rtl a or to a ne arm un er t is permit- c e a app y:
HVAC Gas Tank []Gas Piping —Shutters Q Windows/Doors
�Electric El Plumbing Sprinklers 0Generator Roof
Total Sq. Ft of Constructions: S Ft. of First Floor:
Cost of Construction: $ J .ITO . 0' Utilities: 0Sewer 0 Septic Building Height:
OWNERILESSEE:
CONTRACTOR:
Name r i it
Name:
T
Address: 905 RUA or. �0%E l ifXCZ
City: State:_
Zip Code: Fax:
Phone No. 11 a — ON l - 1410
Company:
Address:•5Id�> AIffl iks- �_„_,,.
City: �r-b-P elc& State: f5f,
Zip Code: •3 415 l Fax:
Phone No.-119-- `r{0(-4111
E-Mail:
Fill in fee simple Title Holder on next page { if different
E-Mail:
State or County Licen e: CACI $ I -3I 3
from the Owner listed above)
If value of construction is $250 or more, a RECORDED Notice of Commencement is required.