HomeMy WebLinkAboutBuilding Permit ApplAll APPLICABLE INFO MUST
I
BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3 30- GLC& Permit Number:
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Property Tax ID #.
Site Plan Name:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION;
Building Permit Application
Commercial Residential )(
Additional work to be performed under this permit- check all that apply:
_Mechanical
Electric
_ Gas Tank
Plumbing
_, Gas Piping
_ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $A5YrQ'___00
OWNER/LESSEE:
Lot No. aczi)
Block No.
Shutters _ Windows/Doors
_ Generator Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
Name
Address:(6 UKS S"T"' _
City: S t _..
State: Fj
Zip Code: Fax:
Phone No. -2 eA 53 a
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name: e1 Z_r�
Company: o C; e11
Address: c, 1 c'---)Lx tAkr--f,
City: r er-c c State:
Zip Code: Fax:
Phone No=(2. fo
E-MalIkLSO/G r- e n. el-9y Q-- Qrr7cl I A',C, is
State or County License
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: _ Not Applicable
!Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name;
Address:
Address: