HomeMy WebLinkAboutpermit application 1ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
- , 4'
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) 452-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: C� �^� C�� 1sr :-� c ► -� i
Legal Description:
Property Tax I #: l �1 Ci' — G % — Co ('^ Cyxi ^J7— Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
fit, C- 4 C G C
,� � �..� , �o�r`•�.�-� ��_�-
CONSTRUCTION INFORMATION:
ACIditional work toe oertormed under this permit — check all appy:
HVAC 0 Gas Tank ❑Gas Piping _ Shutters Windows/Doors
Electric 0 Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction:
Cost of Construction: $ J ` b u
SFt. of First Floor: _
UtiIities:cnSewer ®Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name` rc� c r Y-/_ C
Name: L 1; n
Company: Ci n C
Address: '-'(J c/r-f _
Address a
City: C _ t--� ' e State:
Zip Code: Code: 3 L( 95 Fax:
City: State: )r
Phone No.
Zip Code: , '3y C� a,_;t' Fax: -C-14, e�/` -7
E -Mail:
Phone No.
Fill in fee simple Title Holder on next page ( if different
E -Mail: f�� c� • ; ccj-+ �"'' soh .
from the Owner listed above)
State or County License es Iasi 34- 8 -
If
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.