HomeMy WebLinkAboutBuilding permit appALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I[( 7-0 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: r
Address. [ 141 2-oCz&1Ave• ('6(+- -FlfeV-C2. 3,4q5(
Legal Description:
Property Tax ID #:
Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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Lot No.
Block No.
CONSTRUCTION INFORMATION: I)
11Gas Tank ❑Gas Piping ❑ Shutters a Windows/Doors
El Plumbing r Sprinklers 1:1 Generator 41 Roof
Total Sq. Ft of Construction:1
,SM Cost of Construction: $ 0 .60
Sq. Ft. of First Floor: _
Utilities:Sewer Oseptic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
1
Name:
Address: I4141 UU&I AW. ,
Company:
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City: fi)�LPIPXCe- State: FL
Zip Code: $APW Fax:
Phone No. 51
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Address: PrTUYIIUA, F I
City: fb(-&- e C&
Zip Code: '3 +q 51 I
Phone No. A- 4oLill
State: R_
Fax: -71`L- 4b(s -3 S-1
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E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail:
State or County Licen e:
C.ikC I$ I x I 1p
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.