HomeMy WebLinkAboutBuilding permit appALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: v 120 Permit Number:
ammsaww'11-
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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 I11 i PROPOSED IMPROVEMENT LOCATION:
Address: ✓ i t
Legal Description:
ZZ
Property Tax ID It: F30-W-03(P6-0I0-5 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK;
CONSTRUCTION INFORMATION:
I.V!IHVAC L 1 Gas Tank UGas Piping
1-1 Electric 0 Plumbing ]Sprinl
Total Sq. Ft of Construction: Cost of Construction: $ � pp 0 U /� V . 60i
ers L I Generator
S�Ft`.. of First Floor: _
Utilities: LJSewer Septic
QWindows{Doors
0 Roof
Building Height:
OWNERAESSEE:
CONTRACTOR:
,
Name �,4dfn,
I'I
Name:
Address: I I955$ TY191 2r'b[aA7,
Dr
Company: rL►I
City: (Ad 7) Ls 64--ps State: �
Zip Code::WIP39 Fax:
Phone No.
Addretss:510 h _aM prlu_ �tP BQL�
City: f br b I7f P (f & State: F�fl
Zip Code: '3 +q 5 1 Fax: -77,�-- Lte(o -373-7
PhoneNo_11%9- Lpl-414-1
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: knAp p-a vil k o. CP) fyl
State or County Ucenle: Oce 111-91a (0
If value of construction is 5750la or more, a RECORDED Notice of Commencement is required.