HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: q Permit Number:
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Building Permit Application
Planning and Development services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce Ft 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: L 2
Address: 1 15 _. .
Legal Description: ITD��M PwJS M,IP
Property Tax ID#: ' 0025-ow Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side. Left Side:
[DETAILED DESCRIPTION OF WORK:' R C11'*/
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CONSTRUCTION INFORMATION:
Additipffial work to Iee orme under t ispermit-checka appy:
HVAC LJ Gas Tank I❑�Gas Piping _Shutters ❑Windows/Doors
[]Electric 0 Plumbing L_(Sprinklers 0 Generator Roof
Total Sq.Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction:$ ZoO'0o Utilities:0 Sewer Elseptic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name n 2 alhR Name: W T;,,�
Addr ss: J 3 Sfi Company: j i II t'e.
City: State: F1, Address:5f0 6 Pr-FU,fnafkdL a4j W=
Zip Code: 3 Fax: City, fb6b (E?(cei State: r
Phone No. flfi Zip Code: 34q51 Fax:-77-2=WoO-373-1
E-Mail: PhoneNo.T1g- Wpf-4111
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County Licen e: CAcC 1818I a tP
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.