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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ____________________ Permit Number: _____________________
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial __________ Residential ___________
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: __________________________________________________________________________________________
Property Tax ID #: _________________________________________________________________ Lot No.__________
Site Plan Name: __________________________________________________________________ Block No. _______
Project Name: ______________________________________________________________________________________
DETAILED DESCRIPTION OF WORK:
New Electrical Meter __________ Second Electrical Meter_______________
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit – check all that apply:
__Mechanical __ Gas Tank __ Gas Piping __ Shutters ___ Windows/Doors ___ Pond
__ Electric __ Plumbing __ Sprinklers __ Generator ___ Roof __________ Pitch
Total Sq. Ft of Construction: ___________________ Sq. Ft. of First Floor: _________________________
Cost of Construction: $ _____________________ Utilities: __ Sewer __ Septic Building Height: __________
OWNER/LESSEE: CONTRACTOR:
Name__________________________________________
Address:________________________________________
City: _________________________________ State: ___
Zip Code: ______________ Fax:____________________
Phone No.______________________________________
E-Mail:________________________________________
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name:_________________________________________
Company:_______________________________________
Address:________________________________________
City: ______________________________ State:____
Zip Code: ________________ Fax: __________________
Phone No_______________________________________
E-Mail__________________________________________
State or County License____________________________
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
12/23/21
X
Fence
1200 Parkland Blvd, Fort Pierce, FL 34982
3409-703-0038-000-7 E 1/2 18,19,20
4
Palm Jr Fence LLC - Fence Line Install
125 Total Feet, White PVC (6ft h)
4400
Lori Blazer Iban Avellaneda
1200 Parkland Blvd Palm Jr Fence LLC
Fort Pierce 2913 Middle Rd
34982 Fort Pierce FL
772 626 6257 34981
loriandchuck03@yahoo.com 772 828 8820
palmjrfence@gmail.com
31765
FL