HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3d`� i t rPermit Number: Vza
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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:
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Address: S60 _ CIVP, 5;-. /'/ �+...-
Legal Description: `c �h5e.!2 ,l k. r
Property Tax ID#: (90 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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itional work to be performed under this permit–check all that appy:
_Mechanical Gas Tank _Gas Piping Shutters
_Windows/Doors
_Electric —Plumbing Sprinklers —Generator Roof Pitch
Total Sq. Ft of
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Cost
Cost of Construction: $ Utilities: Sewer, Se
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Name Jd 7xLc, Name.
Address: Company:
City: State: Address: `
Zip Code:j i/,�1 _. Fax: City: Stat
Phone No. $ 03 Ll Zip Code: e Fax:
E-Mail: Phone No p2 .�
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.