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, Port 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
PROPOSED IMPROVEMENT LOCATION:
Address: g&5 -Z
Legal Description:
Property Tax ID #: 33 ) � -
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:
AM itiona I worK toa er orme un er t is permit - c ec a t at app y:
HVAC Gas Tank ❑Gas Piping ❑Shutters E]Windows/Doors
Electric Plumbing ❑Sprinklers MGenerator F]Roof C� Roof pitch
Total Sq. Ft of Construction: S . Ft. of First Floor:
Cost of Construction: $ 1 Utilities:CnSewer E]Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name_ Vl�i� , �1 Name: YU O
Address:
City:
Zip Code: 3k q 9CFax:
Phone No. bot.5 °-91F l
E -Mail:
State:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Company: b�'"�-
Addres : NL.�7
City: State: FL
Zip Code: Fax:
Phone No. �/7,-2 777-0-010
E -Mail: 44- C
State or County License: �� V
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.