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
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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: T 2dig 4:13d
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Legal Description:
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(00- aa31- ?IIm) L)a)4 #SdC1 Cog 33.33 - 77s
Property Tax ID #: N23- go — 0009 — 0 0,0-2
Lot No.
Site Plan Name:
Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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CONSTRUCTION INFORMATION:
Additional work to be erformed under this permit —check all appy:
LIHVAC s Tank Gas Piping _Shutters Q Windows/Doors
11Electric eplumbing 11 Generator Roof
UPnrinklers — —
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ ��� 0� Utilities: Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
NameName: Caam
Address: -t02 i4vhf) #30� Company:
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City: �-�• �ierCe State: Address: &Q..
Zip Code: 2:;,Ac( -4s Fax: City:
State:,
Phone No. Zip Code: ; NW?,Fax:
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E -Mail: Phone No. G(oc - tfia�
Fill in fee simple Title Holder on next page ( if different E -Mail: _Kjy(.17'��1011u
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from the Owner listed above) State or County License: f.E 0o:10Q
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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