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
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: T �1 / �� /—TeP—j_
Legal Description:_i�
Property Tax ID #: �' )u " C, �(a �� Lot No. f/
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that appy:
HVAC Gas Tank ❑Gas Piping�MGenerator
Shutters Q Windows/Doors
Electric Plumbing Sprinklers Roof Roof pitch
Total Sq. Ft of Construction::
Cost of Construction: $ 750
0
SFt. of First Floor: _
Utilities cn Sewer []Septic
Building Height:
OWN ER/LESSEE:
CONTRACTOR:
Name (� �� l '�
Name:
Address: M 4 E' _ I } I
Company:
City: f + )C \ f °t.,i C Stater
Zip
Zip Code: - �1�i' (_ Fax:
7
Phone No. 7? Z /tel -7 &! `/
Address• ; 1xwQ, 1tvL I3 k . % '/' �.' 1-h-
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City: � � 9`i t�� (J" t State:
Zip Code: ���� 1� Fax:
Phone No. %�,
E -Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail:7�fiC-00 VgLISI
State or County License:
It value of construction is $2500 or more, a RECORDED Notice of Commencement is required.