HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
J 7,
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: To Select from dropbox, click arrow at the end of line I
PROPOSED IMPROVEMENT LOCATION:
Address: (/66_0 5 (141'(eail f -"--)4v&
Legal Description:
s's
Property Tax ID #: cot! y o"t S Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side. Left Side:
DETAILED DESCRIPTION OF WORK:
1 yr % (c: C 1 -L'u eb*-Lk
CONSTRUCTION INFORMATION:
Additional -work to be nertormed under this permit — check all that apply:
F1HVAC Gas Tank 0Gas Piping Shutters F-1 Windows/Doors
Generator
Electric 4Z$Plumbing OSprinklers F_ 0 Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 11
S . Ft. of First Floor:
C_ 1-1
UL111LIC.'). I r_ 1=1
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bDul u ; 1.4; ; I It:Ing LI-11eig,
OWNERAESSEE:
CONTRACTOR:
I S
Name GAJ�l
Name: 51fyt?v
Address: 17 uu 6i Liz
Company:
City: State: F—L
Zip Code: Fax:
3
Phone No. -7",
Address: A40DD-01`i' J
I Lu "
City: 'Fbct CA 'k'_ State: 3
)�Qy
Zip Code:.-? C, Fax:
Phone No. 'T� -77?-&V/ J
E -Mail.
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E -Mail: 1 !` I-QV1ILX2 LOW,
.
State or County License: Crc
It value of construction is 52500 or more, a RECORDED Notice of Commencement is required.