HomeMy WebLinkAboutBuilding Permit ApplicationDate:
L ��� �.!
Plannihg an dbevelopmen t Servi 6 ces
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
X - X
I . lot
Permit Number:
ild'
Bui ng.Per it Application
0
(772) 462-1553 Fax: (772) 462-1578
1
PERMIT APPLICATION FOR,
"i'1 t "t i d
M
Ad -dress, 1(2 O
PropertV Tax ID #:
R
Commercial
Ll�
t
Residential \e'
ac A /oc::74 't,
3yps.
Site Plan Name. Block No.
Project Name:
CONSTRUCTION INFORMATION,
i - nal work to be,peirformed unde
Addit'
"7MMechanaical dopolaw-0 G a s Ta n k
mwww�
r this permit
OEM__M=W-W Gas Piping
check all that apply:
Shutters
Fiwrtrir Plumbin¢ Sprinklers Generator
Windows/Doors,_
Pond
Roof Pitch
Total Sq. Ft of Construction_ Sq. Ft. of First Floor:
Utilities: Sewer septic Building Height:
3
,�o
Cost of Construction: $ -
(pWNER/LESSEE: CONTRACTOR:
Name
Addre
City:
zip Code: 3yps'r% Fax,
Phone No.,
State:t
EaMall:
age ('I'f di IF A&LANLAMaL.nt
Fill In SIM e Title on next P
c�
Addre
Ckty:
any:
ss:
t,
j
Zip Code:
Phone No
F -Mail r
Cownor Hood State o.
f value of truction k 2SOO or more, a RECORDED Notice of CIOMMe
unri license
t
I-lywil Is required.
173
* ow-
State.r L
,