HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABL INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: J �, 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:
Address: 5�?(''(7 Q I✓r �{' l U C2 J' si
Legal Description: M fdd V1 I yuS 5/b `1 U SSe_ in(°ILI- /
Property Tax ID#: 1 1�- -tSIO - 00 q 5 -000" D Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK
S�CGI new UtAno)< 3.5 forl i5 seer
g�li�- A1C, 515tUn ul/ to Ku) her,
CONSTRUCTION INFORMATION:
dl nawor to e e orme under t -checkispermrt a apply:
HVAC 13GasTank ❑Gas Piping _Shutters ❑Windows/Doors
Electric 0 Plumbing Sprinklers Generator Roof
Total Sq.Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 1i Jq•oo UtilitiestSewerE]Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name (k T a at,) Name: ,'
Address, 5510 Company: `{&y4 n
City: Yn( Vitrct State:A/ Address,5(0 A -FU,(ylpi(C¢.. &j&EBL�
Zip Code::3 QSI Fax: city, fbrb—Refc'& State: rl—
Phone No. Zip Code: S"5 ! Fax:
E-Mail: Phone No.-rig-_ 4W-41*1
Fill in fee simple Title Holder on next page(if different E-Mail: i loo. Cf)(n
from the Owner listed above) State or Coun : Cd4C 181813 LP
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.