HomeMy WebLinkAboutBuilding permit app pg 1ALL APPl.l~LE INFO MUST BE COMPLETED FOR APPLICATION TO BC ACCl;PTCD
Date: .2t-11l:U PermitNumber: _______ _
COUNTY ""
FLORlOA.
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: To Select from dropbox, click arrow at the end of line
Address: ;,..4 r oles O /;e, =l--Plifc.e.. 31.jqS(
Legal Description: 'S'fU'll$1A IA.us. Co~ Club /
Property Tax ID#:________________________ Lot No. ___ _
Site Plan Name:________________________ Block No. __ _
Project Name: _______________________________ _
Setbacks Front. ___ _ Back: ___ Right Side: ___ Left Side: __ _
I DEtAtLEO OE$CR1PT1QN OF WORK:
CONSTRUCflONIHFORMATION:
Gas Tank as Piping
D Plumbing Osprinklers
Shutters
□Generator
0 Windows/Doors
□Roof
Total Sq. Ft of Construction: ______ _
Cost of Construction: s _i.\_lOO-=-.--'(l)=-----
59:£!; of First Floor:
Utilities: Usewer Oseptic Building Height: ___ _
OWNER/LE$SEE:
Name_::]:.r.t'.]l£1ll:l.,_,-=~~~~!.&'-------
Address:.-"!"--'Li-"'>'"'--'..__,...,........,,..,_,_=-<'-------,,--
City: fi,.t)iif(l-State: ft.-
Zip Code: ?>iltl.1:i l Fax:, _______ _
Phone No. ')Jfe •3~\ • %5SX
E-Mail: ______________ _
Fill in fee simple Title Holder on next page ( if different
from the OWner listed above)
. CONTRACTOR:
Name: M,!£.!1CL!li...p_J2!zy.J~---,--.,.,...--:-:--=--
Company:
Address:52Jf~O~A-l]M!]l.{!J.k~[ud?Jt:J~~:'.__
City: f'ofb' H'l(c.e., State: Ft...
Zip Code: ·'.3!:/15 l Fax:71:L-'-tl,f· 3731
Phone No.--na,-Lf<o{-4141
E-Mail:~leac (.! l,/ll boo. Co C!] .
State or County Licenk e.Ac I~ I '3 I -a \I
If value of construc:tlon Is $2500 or more, a RECORDED Notice of Commencement Is required.