HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
A I J1 _
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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
PROPOSED IMPROVEMENT LOCATION:
Address: `�`� �' \ (`
—a
Legal Description:
Property Tax ID #: 3 --� U CN - jp 0 C7' - CD E- CXXJ_ '--5- Lot No._
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
HdoltiOnal worK to ne ertormed
HVAC ! Gas Tank
under this permit— check all
❑Gas Piping
that
apply:
Shutters
E]
Company: co' •� - :- `. °
City: - - ,Cer State:
Address:`7
Zip Code ,1 Fax:
City: -Ce(e Stater
_
Zip Code: 3LI S Fax: '�-(V L/- //,b
Windows/Doors
Phone No.
11
Electric
from the Owner listed above)
Q
Plumbing
Sprinklers
Generator
Q
Roof
Total Sq. Ft of Construction:
Cost of Construction: $<
S Ft. of First Floor: _
Utilities:Sewer Septic
Building Height:
OWNERAESSEE:
CONTRACTOR:
Name
Name:
Address:` ,- w►
Company: co' •� - :- `. °
City: - - ,Cer State:
Address:`7
Zip Code ,1 Fax:
City: -Ce(e Stater
Phone No. J '?r_J 6�
Zip Code: 3LI S Fax: '�-(V L/- //,b
E -Mail:
Phone No.
Fill in fee simple Title Holder on next page ( if different
E -Mail: C' CS r ;.,,.4 C - AL ,.
from the Owner listed above)
State or County License: CAC 1�5
it value of construction is $2500 or more, a RECORDED Notice of Commencement is required.