HomeMy WebLinkAboutHeiserman AC Change out Permit pg 1 001ILL APPU LE INFO MUST BE COMPLETED FOR APPLICATION To BE ACCEPTED
Date: F f 5 Permit Number:
Building Permit Application
Planning and Developmentservices
Building and lode Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34981
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: r (,
Legal Description:
oarnrfwe�
d1
Property Tax ID #: 0 `T- Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back Right Side: Left Side:
aadm i workto he ertormed
HVAC E] Gas Tank
Electric 0 Plumbing
under this permit— e
[]Gas Piping
Sprinklers
a
Name: IG Yi
app
Shutters
Generator
F]
❑
WindowsfDoors
Roof . _
_
11
Total Sq. Ft of Construction:
Cost of Construction: $ 3506.00
Sq� Ftt.. of First Floor:
Utilities:( ISewer1-1Septic
Building Height:
OWNERALESSEE
CONTRACTOR:
Name
Address: I Cr�vv _
Name: IG Yi
Company: r d
City: 771'1 State: �(/
Zip Code: Fax:
Phone No. ri rJ —
Addreffs��s: 5I0 TGCYf 1P1
City: r(OCL Ktrte , 7 State: FLI
Zip Code: 94QS II' Fax:1 la 3731
Phone No. "n I-- 4(0 [ -J+I+l
E -Mail- N
A
Fill in fee simple Titre Holder on next page I if different
from the Owner listed above)
E -Mail: , 1PAC 0,C(A
hJD XQ(11
State or Co my License: __I$I$Ig (0
n varve of consovrnon is >cauu or more, a KLtuKVKJ rvonce of Commencement is required.