HomeMy WebLinkAboutBuilding permit app pg 1 001ALL APPLICABLE 1 IFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Ito i
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-SS78 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
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Legal Description: IL�
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Property Tax lD #: 130 o q- 0D0 - L0 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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`CONSTRUCTION INFORMATION:
Additijfna work to e e orme under tispermit—checka apply:
HVAC 13GasTank []Gas Piping _Shutters ❑Windows/Doors
❑ Electric ❑ Plumbing Sprinklers ❑ Generator Roof
Total Sq. Ft of Construction': P S� of First Floor:
4�P Cost of Construction: $ QU . 0o Utilities: Sewer n Septic Building Height:
OWNERAESSEE:r
CONTRACTOR:
Name
Name:
Address: 156Z) Jtft- izt, U,
Company: P?D�6j0_ At( tY�I f j�V-199�(A�
City: �OA-P)d� State: '%
Zip Code: 311q 5 l Fax:
Phone No. 5I-1 - 41 D - l! 4 0
Addretss�:510 Ar TU,r1 aik-iL *4C W-8d —
City: YUC&-f f t rc& State: PL
City:
Zip Code: .3 4-61 5 I Fax: -71a- 460 -373`1
Phone No. -A`%`.>! - 4W -li 14-1
E-Mail:
Fill in fee simple Title Holder on next page I if different
E-Mail:
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State or County Licen e: C�e('i l8 (8l iS ID
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.