HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 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
Pi20'POStD IMPROVEMENT LOCATION:
Address: i`J(� 1,6_ ffLrY 1a Vt-,�Tf\ 6-0-1 , �c)g_T .;A,rs ISJCti 3 i9S�l
Legal Description: ZN\K.R- VAC4 - k)yok'�- U tStX 3`6 L075 I rnAP �N�28N�LUR 3653 1744'
Property Tax ID #: Lot No. 5
Site Plan Name: Block No. Ilk
Project Name:
Setbacks Front Back: Right Side: Left Side:
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HVAC Gas Tank MGas Piping Shutters ❑ Windows/Doors
Electric F]Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction:$ 2,500' 00 Utilities:llSewerElSeptic Building Height:
Name t AOm iz Wfl fJ irviOU Name: ALVUVnor J , j, ' >k ,. j ,i+,�:
Address: $2G0 5wN_s M Company: 04)6UiS Ails C0rufJi-r10AJirJG
City: MC l B A N State: VA Address: ISI CA -RT 55 ST -
Zip Code: 21102 Fax: City: 141 r\ L)Z 1 A Stater
Phone No. zip Code: ',�-to 13 Fax: 7. 4936
E -Mail: Phone No. 305' 9tLu - `ate S'
Fill in fee simple Title Holder on next page ( if different E -Mail: AI✓L S Gk"f4rL. - CO w%
from the Owner listed above) State or County License: GAC l? Q-)'$ 3
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.