HomeMy WebLinkAboutwalsh page 1 appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
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Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
FROPt��ED. INPRC}VEIVIENT- l
Address:
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L`e�gal Die-s�,cr/iption: S � L C%i�
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Property Tax IC
Site Plan Name
Project Name:
Setbacks Front Back:
DETAILED QESCRIPT'ION `OF WORK:
Permit Number:
Building Permit Application
Commercial Residential s�^
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CQNSTRUCTIC}N 1NFQRMATlON:
rtiona wor to e per orme un er t is permit- c ec a t at app y:
_Mechanical —Gas Tank —Gas Piping _Shutters � Windows/Doors
_Electric _ Plumbing —Sprinklers —Generator _Roof Pitch
Total Sq. Ft of Construction: �� ��, Sq. Ft. o�f First Floor:
�� UtiliteS. Sewer Septic Building Height:
Cost of Construction: $ � �� � __. —
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Address:�i� f�-Uvt �'�„�,/'a L li��'
City. � 3� � � � - UC i �- State:��
Zip Coded �� ��--��' Fax: ��' ,
Phone No.� � b���-'S� � / _
E-Mail: ,/1/ / i __
Fill in fee simple Title Holder on nFxt page (if different
from the Owner listed abo�ae�
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Name: ���,'�[rict�c���r����
Company:. ��, (�i � ��/-��/`�Tr (/b'bt,i�i ir',� i,�i.4
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City: �✓ +�_ �= State:,�f.,
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Zip Code: � c � _ --_
Phone No �� � � �-` °� �-�
E-Mail ti-.6�. C�c/�i/ � i�fit � t`p ��/!�
State or Cou y License ����
If value of construction is 25sJ0 or mare, a RECORDED Notice of Commencement is required.