HomeMy WebLinkAboutJACKSON PERMIT APPAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �I i i 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
PERMIT TYPE: E L E(CT_ Jt Al _
Commercial Residential
Address:
Property Tax ID #: Lot No. UA
Site Plan Name:
Project Name:
Additional work to be performed under this permit - check all that apply:
Block No.
Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: Utilities: —Sewer —Septic
Name __101'l 11 lSGC�I"> rW
Address: e1c�\�- 'f�&'Ai i
City: 1_-c _ P eL(L State: ,
Zip Code: _3yC\c3\ Fax:
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name:
Roof Pitch
Building Height:
Company: \-�(x+Li �U ClC y)-VJ �S
Address: �C�,\C) IR6 .
City: �4 . �\6eY State:
Zip Code: ?J�A(1(�a- Fax:lol-�i��_`�
Phone No lo1- 'ZA� 9
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State or County License ELF \-;')(�)Q
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.