HomeMy WebLinkAboutBuilding permit app .ALL APP i ICA INFO �BjE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: / Permit Number:
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 V
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION
Address: �2�'�
Legal Description: LA
Property Tax ID#: QL 3�P-Q--)a 0-C)Z.g e 00C- � �} Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION'OF WORK.
CQNSTRUCTION INFORMATION
Additional work to be performed under this permit-check, all apply: _771
aHVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Electric Plumbing Sprinklers E Generator El Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 'LJ U Utilities Sewer[]Septic Building Height:
.OWNER/LESSEE: , r " CONTRACTOR:
Name �-I I CAI C_& Name: e��,c->1-1 r��rt W'C9wnS
Address: BC,-3'2 Company:1 iokC>_k L-x&e t IPCr'Af>, i► C.
City: State:`2 Address:Z aQ S -rzo i n nC,k_--, +r 1
Zip Code: :3,Ltci LrS Fax: City: Stater
Phone No. MQ �n� I I�_ �� Zip Code: �CILA s Fax:
E-Mail: @ Phone No.'Z-)•Z-Ct iG- k3.?
Fill in fee simple itle Holder on next page(if different E-Mail:
from the Owner listed above) State or County License: G C I t-i - )
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.