HomeMy WebLinkAboutHatter AC Permit App pg 1 001ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
® : 4
Building Permit Application
Planning and Development Services
Building and Code Regulation Division /
2300 Virginia Avenue, Fort Pierce FL 34982 v/
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 LOCATIO_N.
Address: 2 On5YA. (rLp31VA rY-b YiIJC- 34151
� 3Legal Description: 000k ,M- if Pki
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Property Tax ID##43of -wl- oi(Lol – Io-(o Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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CONS)RUCTION INFORMATION:
i ona workto e e orme under this permit –check a appy:
_ HVAC LJ Gas Tank ❑Gas Piping Shutters Windows/Doors
1-1 Electric R Plumbing ❑Sprinklers Generator Roof
Total Sq. Ft of Construction: Ap�T1 S Ft. of First Floor:
Cost of Construction: $ 000 - VD Utilities:[]Sewer 0Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
Name: N e _
Addre{s�s���'^
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Company: ip kr-
State:
City: rUfL I�IC(i� State:
Addres/s:�rJlfl�J
City: rot 11urf, S`t1ate:FG
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Zip Code: MR 6A Fax:
Phone Ni_o.'Z�–�iipi�I�i�I
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Zip Code: M5 Fax: IJ /A
Phone No. 2.� 4 SR8tF
E-Mail
Or
Fill in fee simple Title Holder on next page ( if different
E-Mail: 6itial C\JLLi'100.IIDW
State or County License: Cr/i` l4{lBl$(c
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.