HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONJ f
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ,I q
Date: N6 1 4
Permit Number:
SIR MEMO
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
RECEIVE®
OCT 01 Z018
icie County,, Perr
Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line �p• yqQ, j.g�
Address:
Legal Description: flT n (-bI (— 000 ^ 3
Property Tax ID #: Lot No.
Site Plan Name:
Block No.
Project Name:�`r/11f�if�p��
Setbacks Front Back: Right Side: Left Side: n (�
E1HVAC H Gas Tank Gas
Electric 0 Plumbing �Spr
Total iSq. Ft of Construction:
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Cost pf Construction: $ zo(7_ 00
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Ft. of First Floor: _
ISewer []Septic
Name // 107 hc;m r=L2 Name:
Address: ��� - Company:
City: I A"f , &-rGe— State: 2X_ Address: _
Zip Code: c6 Fax: City:
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Phone No. �� - 3� G/` / Zip Code:_
E-Mail:
Fill in -fee simple Title Holder on next page (if different
from the Owner listed above)
Phone No.
E-Mail:
State or County License:
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
Windows/Do
oof E/
Building Height:
Fax:
State: