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HomeMy WebLinkAboutapplication pg 1 All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: J(10 O(j Gall rnl i 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: Address: Legal Description: Property Tax ID#: 13 C6 `3q1 _000a • w©J Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: MSIR L. A61" L LA/6 %0144510GC4�Q4 40 x �eD Additional work to be performed under t is permit–check all that appy: _Mechanical _Gas Tank _Gas Piping _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 `L 0 (1 Name: Address: I Q !�� � � Company: M City: /^� i e nC E state:LL Address: Zip Code: y Fax: City: State: Phone No. r/ S Zip Code: Fax: E-Mail:: E(7� G N� Phone No Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State or County License If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.