HomeMy WebLinkAboutPIPER PERMIT PAGE 1All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: d`��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 APPLICATION FOR:
PROPOSED INPROVEMENT LOCATION
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Address: [ Q r(;C" Et G -
Legal Description: Z
Property Tax ID #: "®�� d��� Lot No.
Site Plan Name: CIVVjjit P Block No.
Project Name: o
Setbacks Front Back: Right Side: Left Side: ,
DETAILED DESC91PTION OF WORK:
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CONSTRUCTION INFORMATIOIt
onn er t is permit — c ec a that apply:
Mechanical Gas Tank _ Gas Piping _ Shutters _ Windows/Doors -
_ Electric _ Plumbing _ Sprinklers Generator Roof Pitch
Total Sq. Ft of Construction: _` / (� -Sq_ Ft. of First Floor:
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Cost of Construction: $ C;t o o d Utilities: = Sewer —Septic Building Height:
O NE $� E;
CONTRACTOR -
Name (,cc rz f1t, e l�
Name:
Address: G 4 c5' rq
Company: y Cr mil" 'ta io't 1! li✓��
City: State:
Zip Code: Fax: /l/
PhoneNo. t
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Address:
City: F61 State:
Zip Code: `t`�l - Fax: '?
Phone No
E-Mail✓U jirC.
State orCouWtv License'
If value of construction is 2500 or more, a RECORDED Notice of Lommencemema is requires.