HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE 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 x
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description:_
Property Tax ID#:_ Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front_ Back: Right Side:_ Left Side:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additional work to b rformed under this permit—check all that apply:
❑✓—HVAC Gas Tank Gas Piping ❑_Shutters Windows/Doors
11 Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: _ S Ft. of First Floor:
Cost of Construction: $ 5400 Utilities:n Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Name: David Kruse
Address: Company: AC Doctors Inc
City: _State:FL Address: 1853 Biltmore Street
Zip Code: Fax: City: Port Saint Lucie State: FL
Phone No. _ Zip Code: 34984 Fax:_
E-Mail:_ Phone No. 772-344-3944
Fill in fee simple Title Holder on next page ( if different E-Mail: acdoctorsinc@gmail.com
from the Owner listed above) State or County License: CAC058461
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.