HomeMy WebLinkAboutBUILDING PERMIT APPLICATION-..-
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Dater 11 \ �� Permit Number.
RECER"I JUL 2 0 2016
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+ Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 Residential
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
PERMIT APPLICATION FOR: To Select. from dropbox, click arrow at the end of linej' R
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Address:
Legal Description: 7 /w
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�? U Property Tax ID #: Lot No.
Block No.
Site Plan Name: /
Project Name: !�w
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Setbacks . Front6�Back: d Right Side: Left Side:
ILED DESCI�l1�16�OF UUTUf�K`'� � � ,
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a wor to e e orme un er t is permit — c ec a apply: �\
Gas Tank ❑Gas Piping _Shutters Q Win�lows/Doors
[]S Generator Roof
umbing []Sprinklers - �Electric . 'Plu_ 2,
Total Sq. Ft of Construction: C35�1S S . Ft of First Floor:
Cyst of Construction: $
SkI 4 . tv Utilities Sewer 0 Septic Building Height:'
Name Name:
Address: Company-;Company-;45 J
City:
t Address:
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Zip Code:�Y'7f (, Fax: City:
Phone No. ��t7r%'' ��� -a?3� Zip Code: q l �
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Phone No. /-7Q�
Fill in fee sie. Holder on next page (if different E-Mail: �AAI
from the Owner listed above) State or County License:
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.