HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: r I Permit Number:
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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 X
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATIOW
Address:
Legal Description:
Property Tax ID #: ) a3-0, i/ _
Site Plan Name:
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Project Name:
Setbacks Front Back: Right Side: Left Side:
Lot No.
Block No.
Replacing A/C, exact change out, no duct work with Gail �lZ 3 • S��-D>#--�6
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VVHCtom (E3, f-")flo5t-
Aaaitionai wom to ae errormea
OHVAC Gas Tank
unser tnis permit — cnecK all
❑Gas Piping
apply:
Shutters
❑
Windows/Doors
City. .TZ _ 3 _ State: _ �'
Zip Code:Fax:
_
Phone No. Z 8 -- D qZip
Code: 3296[] Fax: 772 7949783
11 Electric 0 Plumbing
[]Sprinklers
11 Generator
O
hoof
Total Sq. Ft of Construction:
Cost of Construction: $ 7 L(51 L"
S Ft. of First Floor: _
Utilities: Sewer Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name 'fi
Name: Zacek, Dennis
Company: American Residential Services
Address: 2840 US Hwy 1
Address: ]�7S ,5 '` DrZ« {-� ll
City. .TZ _ 3 _ State: _ �'
Zip Code:Fax:
City: Vero Beach State: FL
Phone No. Z 8 -- D qZip
Code: 3296[] Fax: 772 7949783
E-Mail:
Phone No. 772 794-7221
Fill In fee simple Title Holder on next page ( if different
E -Mail: a 06)4j C�t�
from the owner listed above)
State or County License: CMC1249753
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.