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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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
€'ERMIT A!'PLICATIC�N FOR: T© Select frnrn dro�box, click arrouv at the end caf line v -6I
PROPOSED IMPROVEMENT LOCATfON:
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Address: 40o WF(oncA_1Q,n I)V,
Legal Description: �r_, Woocllav x(tc
Property Tax ID #: R/5- 70/ -,;2
Lot No._
Site Plan Name: Block No.
ProjectName:
Setbacks Front— Back: Right Side: Left Side:
CONSTRUCT ON INFORMATION:
Aitiona iii:iil 11; to E 3e orme un er t is permit
HF�71
VAC :k aTF Windows/(}cors
1:1 Gas Tank F]Gas Piping
Electric UkPfumbing OSprinklers [lenerator 1:1 Roof
Roof pitch
Total Sq. Ft of Construction:
Cost of Construclion. $ 765
S . Ft. of First Floor:
Utilities-cn Sewer El Septic
Building Height:
OWNER/LESSEE: CONTRACTOR:
Name
Address:A)o "Luom((Q�Idc f),,z Company- eta"Q
>
City: Stater Address:
Zip Code: Fax: City: _Rbc,4 S t state: PU__
Phone No. -x`7(255 Zip Code: RUC -1 Fax:
E -Mail- —_Phone No. '"a-_777
Fill in fee simple Title Holder on next page if different E -Mail: PV 114-'l
from the Owner listed above) State or County License, 0
0
If value of construction is s2500 or more, a RECORDED Notice of Commencement is required.