HomeMy WebLinkAboutBuilding Permit Application- ALL APPLICABLE Nt FAO MUST BE COMPLETED FOR APPLICATION TO BE. ACCEPTED
Date: ���-[�(� Permit Number:?
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Building Permit Application
Planning and Development Services QpR 14.1015
-Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 p RMITr.
Phone: (772) 4.62-1553 Fax: (772).462=1578' CommercialReside�atci ounty�FL
PERMIT APPLICATION FOR: TO -Select from dropbox, click arrow at.the.-end_ of line
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Descriptionch.rw crr' c�c1C
Property Tax ID #: lz a14A — 0 Lot No.
Site Plan Name; ' en�l��e �� Block No: .
Project NamerIP
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Setbacks Front Back: Right Side: — Left Side:
DETAILED DESCRIPTION OFF WORK:
(CONSTRUCTION INFORMATION:`°
Additl9rial wor to l3e.'pertormed..under this permit —check a. app y:
OHVAC - Gas Tank.. Gas Piping _ Shutters ❑ Windows/Doors
0 Electric D Plumbing - ❑Sprinklers .q Generator Roof
Total. So. Ft of.Construction: Sq. Ft. of First Floor:
Cost of Construction: Utilities: Sewer Septic Building Height:
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OWNER/LESSEE: _
CONTRACTOR:_ . .
Name `
Name:,
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Address: C"
Company: �i�> .�R.S�
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.City: State:.
Address:-A�
Zip Code: ' Fax:
City� (�X sn. Q�,N-
State�t,
Phone No
Zip Code:
Fax:
E-Mail:.
Phone -No. `1�a.'-7c��`��`��1
Fill in fee simple Title; Holder on.next page (if different
E-Mail•
from the Owner listed above).
State or County. License::
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If,value of construction is $2500 or, more, a RECORDED -Notice of Commencement is required.