HomeMy WebLinkAboutSayer AC Change out Permit App pg 1 001LLL APPLI ABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: i- 18 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 �II
PROPOSED IMPROVEMENT LOCATION:
Address: — I.rCI
Legal Description:
Property Tax ID #: (501 (013-01 VP —ow -5 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Ib_fi(UkU-. Ons -fail atm Leflrlo)c a.5 fon Pfs'esc
5?Lii- MC s4s4-tm w4ii to J<W vlt
CONS UCTION INFORMATION:
Additl9rhalworkto e orme is un under t permit — c ec a appy:
HVAC (_J Gas Tank ❑Gas Piping _ Shutters F]Windows/Doors
11 Electric 1:1 Plumbing Sprinklers 11 Generator Roof
Total Sq. Ft of Construction: A� S Ft. of First Floor:
Cost of Construction:$ 3�00,0o Utilities:llSewerOSeptic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name ►t1'11� C
Address:l�d1 t1A
Name:
Company:
�D
City:vb(t pfiwe, State
Zip Code: 34g51 Fax: R1 A
Phone No. 50— 383-3441f
Address:15163 NTt tarn
G2kJJPRr
City:-[; 1 I'fC�
zip Code: S Q51
Phone No.1-4[A
State:
Fax: `lZ1-11(p(p-3131
I
E -Mail: fJJA
Fill in fee simple Title Holder on next page I if different
from the Owner listed above)
E -Mail: b`}rAIfD
C90
State or County License: l'SLl$�O
It value of construction is $2500 or more, a RECORDED Notice of Commencement is required.