HomeMy WebLinkAboutBuilding Permit Application N
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:_ " 005)
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
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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
PR;OPC}S,ED IfVLPROVEM"ENT LOCATIQN
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Address: �l" 3.,
Legal Description: 06iAd—7 14/9'j� 3
COK 37Q��- 5�g)
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Property Tax ID#: Q CtDo Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK
CO'_NSTRUCTIO.N INFORMATION
Additional wor to be erformed under this permit-check a at app y:
HVAC Gas Tank ❑Gas Piping In Shutters Ei Windows/Doors
Electric ❑ Plumbing Sprinklers I Generator E:U_ oof
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ v Utilities. E Septic ;Building Height:
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Name Name:
Address: ~ - ' Company:
City: / State: Address:
Zip Code:
Fax City: State:
Phone No. Zip Code: Fax:
E-Mail: Phone No.
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.