HomeMy WebLinkAboutORIGINAL PERMIT REQUESTC
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: ,' Szz Permit Number:
ii�s O Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 e
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential V
PERMITTYPE:
Address: <} 3 472ricr�
Property Tax ID #: Lt k C1 — s \ _ 00 30 Lot No.
Site Plan Name: Block No.
Project Name:
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Additional work to be performed under this permit —check all that apply: `
_Mechanical _/Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
_ Electric t� Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ O , (,7' Utilities: _ Sewer _ Septic Building Height:
Name
Address: "�-t 'c�*t3e Se C a c l
City: Q1 - S 7 - i J C�rz State:
Zip Code: LtOt &sj Fax: u A -
Phone t- t Z
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name:
Company: 'z-t pro rw4r�;
Address: L►
City: r ` r C✓4 State: i=C.
Zip Code: Fax: 1i" A
Phone No
E-Mail
State or County License L i C_ t 14 7. 0t'5 i
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.