HomeMy WebLinkAboutapplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I I 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
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION: I
Address: N 01 —Z
Property Tax ID #: -�' ! O Lot No.
Site Plan NamE
Project Name:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
Mechanical Gas Tank _ Gas Piping _ Shutters
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction: T/�
Cost of Construction: $ .Z , C4 40 - 0
_ Generator
Sq. Ft. of First Floor
Windows/Doors
_ Roof Pitch
2.Ld 4 -)—
Utilities: —Sewer _Septic Building Height: I �-_
OWNER/LESSEE:
CONTRACTOR:
Name Q
Name: CAaWT ,(� y • t" l-kimm
Address: I L - 1 N
Company: cn
City: k' Stater
Zip Code: y .3 Fax:
Phone No. 016L -l62' - ax1" I y
Address: 1� # 303
City: �)�i1P12�� State:
Zip Code: 3c�14`(Fax:
Phone No 't l)1 "l b `�t 2
yre^
E-Mail: r) • `C -� �� ��J� ��1f1'1UtiI
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail_` �`�m1 �"�� c5ifX1'Y��'PGN'Y1VcSi9
State or County Licensee f G 3 3 13 L
If value of construction is $2500 or more, a RECORDED Notice of Commencemem is requires.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.