HomeMy WebLinkAboutpermit application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED + ,
Date: I� '�"Ily 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
PERMIT APPLICATION FOR:
PR®POSED I�NPR41/EMFEN _ LOC TI0'N•
Address:
Legal Description:
Property Tax ID#: 1,30 (D 13-2 OO Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front , Back: Right Side: Left Side:
FI* IED D'E�SCRIPT ONO WOR
CONSTRUCTIO' N �O A ON:
Additionalwork to be pertormed under t is permit—check all that appy:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ C2 _C Utilities: Sewer _Septic Building Height:
0 NER LE=�S�S�E; CNam olgimo
Name Name:.I,
Addre$3� 2-0 Company._
City: State: Address:
Zip Code: Fax: City: State:
Phone No. - Zip Code: Fax:
E-Mail: • tj ZJ Z ( Phone No
Fill in fee simple Title Holder on next page (if i Brent 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.