HomeMy WebLinkAboutMARSCH 1ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
•
BUilding Permit Application
Planning and Development Services
Building and Cade 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: _1- 3 % [DY-11.V%,tCJW-ti [.tee ems... I C"T . -
Legal Description:
Property Tax ID #:I -. -2 C ( IJ CM C) - Lot No.—C
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
CONTRACTOR:
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CONSTRUCTION INFORMATION:
Address: 19-2 [.oy,t rQt,�, e,:.� 1 c7` -
Company:
Additional work toa
HVAC
11 Electric
er orme under
13 Gas Tank
0 Plumbing
this permit - check a
E]Gas Piping
Sprinklers
Address:
appy:
Shutters
Generator
Windows/Doors
El Roof
_
El
Total Sq. Ft of Construction:
Cost of Construction: $ L
SFt. of First Floor: _
Utilities:cnSewer D Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name�.. � ✓ti'ti Cti
Name:
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Address: 19-2 [.oy,t rQt,�, e,:.� 1 c7` -
Company:
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City: i� 0 � e rc e _ State:
Address:
Zip Code:3S(5 4 9 Fax:
City: Y -
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State: t:,i_
Phone Na. -)I)L- `�"�iLr " `t�
Zip Code:
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Fax: L(C/ V
E -Mail:
Phone No.
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Fill in fee simple Title Halder on next page ( if different
E-Mail:%J
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from the Owner listed above)
State or County License:
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it value of construction is 52500 or more, a RECORDED Notice of Commencement is required.