HomeMy WebLinkAboutNettles Install 1ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
-', j•
-11
Building Permit Application
Planning an Development Services
Building ana Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (77 2) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT ArPLICATION FOR: To Select from dropbox, click arrow at the end of fine
PROPOSEO IMPROVEMENT LOCATION:
Address:
Legal Description:
C
Property Tax ID #• 1
e �� '1 �; 1 � �� - � � •— `� Lot No.
Site Plan Name:
Block No.
Project Name:
Setbacks F ont Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
C ts
R'�fA N a 3 G 1'cQt� AuA
CONSTRUCTION INFORMATION:
Additional worK toe e orme un er this permit — c
HVAC Gas Tank []Gas Piping
Electric Plumbing Sprinklers
Total SQ. Ft of Construction:
Cost of Construction: $3 L p ,, Uti
OWNER/LESSEE:
Name
Address: .
City: State: _
Zip Code; Fax:
Phone Na.
E -Mail:
Fill in fee simple Title Halder an next page ( if different
from the Owner listed above)
apply:
_ Shutters
Generator
SFt. of First Floor: _
lities:ISewer Septic
I ( Windows/Doors
1 Roof Roof pitch
S L-1 C)
Building Height:
CONTRACTOR:
Name: (Z. z e.,. i
Company: c 1 e r
Address: i v -c r
City: _ i a F' ; State:
Zip Code: S2_ Fax:
Phone No. Z - L �
E -Mail: o y
State or County License: X Q
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.