HomeMy WebLinkAboutBuilding permit app pg 1ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: j Permit Number:
® Building Permit Application
Planning and Development Services
Building and Code Regulation Division /
3300 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:
Legal Description:
Property Tax ID #:
Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side: Left Side:
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK:
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CONSTRUCTION INFORMATION:
All ItI a wor to e e orme under thrm ispeit -C hec a apply:
_HVAC 11GasTank DGasPiping _Shutters ❑windows/Doors
Electric 0 Plumbing Sprinklers 0 Generator 0 Roof
Total Sq. Ft of Construction: Cost of Construction: $ 4,60 . DO
S Ft. of First Floor: _
Utilities:ll Sewer 0 Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name ZfL"0
Name:
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Address 3 vlµrut. Ci�e�—
Company:
City.171(Q Stater
Zip Code: 3"5 1 Fax:
Phone No. J,14-e211q-U'3%
Address: NO ii-T,(rl�fke- E'
city: fb(-bi Rerce,
Zip Code: 34151
Phone No.— (A- 4YB(-414-1
State:
Fax: 7Ua-4(YO 373-7
E-Mail:
Fill in fee simple Title Holder on next page I if different
from the Owner listed above)
E-Mail: �A Wb00.
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State or County Licen e:
CAC 181x l $ (P
It value of construction is $2500 or more, a RECORDED Notice of Commencement is required.