HomeMy WebLinkAboutBuilding Permit Application .PPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
'bate: 9 -':5-) 5 Permit Number:
Building Permit Applicatidn
Planning and Development Service$
Building drnd Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
FPERMIT APPLICATION FOR:
Address:. (3,\LL,.,.
Legal Description:
Property Tax ID#: Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Fronl�-_ Back: Right Side, Left Side:
I/Re- ece OAfisc a-4.-
Additional Work to-be performed unclerthiS permit-crieck all that apply-,
Mechanical —Gas Tank Gas Piping T Shutters Windows/Doors
Electric Plumbing Sprinklers Generator Roof
Total Sq.Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ Utilities: _Sewer _Septic Building Height:
'Name, sa-mmon -5
Nam
Address: 5'51: L16 KjarCp-[) a\1e.- Company-., �t-r�Sfe&r C,
City: "J V1 nwN Dr
LA-b-Ir U)CCe-) State:EL, Address: 15 ' 16QP-,Q
Zip Code: Fax: City: 'Pegg S-r 1 tC►e. State--LL
Phone Na. rl-1 Z---3-40 Zip Coder 342,2v Fax: 335-. ).4o
E-Mail: Phone No. 712 3M -30-32,
Fill in feesimple Title Holder on next pa96(If different E-Mail; 0--,LLtA1r ;5Lkq V r
from the Owner listed above) State or County license: CAC 05 i, 10
if value of construction is 258Tor more,a RECORDED Notice of Commencement is.required.