HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1I 15 Permit Number:
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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 Residential
PERMIT APPLICATION FOR To Select from dropbox, click arrow at the end of line
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P"'OpQ�ED IIVIP O EME OCATiE 11
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Address:
Legal Description:
Property Tax ID#: Lot No. I r) _
Site Plan Name: Block No.
Project Name7DIt4Mond pnds ?14 2
Setbacks Front S• Back: q O Right Side: 9 - (e O Left Side: 'I
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AClaitional work toe nertormed under t is permit-check all appy:
HVAC Gas Tank ❑Gas Piping _Shutters Windows Doors
Electric E] Plumbing ❑Sprinklers ❑Generator ❑_Roof
Total Sq. Ft of Construction: 5, 05's. S . Ft. of First Floor:
Cost of Construction:$4k`5p, `� UtilitiesInSewer❑Septic Building Height:
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Name q3 �, �t 3 -�-t
-- � _ �►� �'a1 t �a � Name:
ACompany: f- `
City: State: Address:IS! .
Zip Code: Fax:-o"Z Fax: City:W G54-ftm Bcocj� State:
Phone No. Zip Code&y 12, Fax5L "p�0y
E-Mail: Phone No.,G591 - 94 -3(0
Fill in fee simple Title Holder on next page(if different E-Mail: Cisc)®thQ�
from the Owner listed above) State or County License-.WL)- 1
If value of construction is$2500 or more,a RECORDED Notice of commencement is required.
NOV-24-2015 02:58 From: 5612846103 To:17724621578 Paee:2/2
20151123140230606.pdf 11
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