HomeMy WebLinkAboutTheoret AC Change out Permit App pg 1 001ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3 �� q Permit Number:
Building Permit Application
Planning and Code
ion Dices
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce Ft 34992
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: III
Address: ILV
Legal Description:
Property Tax ID #:
Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side: Left Side:
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK:
UV y Pa. GWI W 3 ton (4 5668 f ni9i ainv
(,6ft wlAV\ [ D Kuiln2ctL -
I CONSTRUCTION INFORMATION: III
L=YJHVAC LJ Gas Tank "Ga!
11Electric E] Plumbing 0SPI
Total Sq. Ft of Construction: I I rti�l�
Cost of Construction: $ � 1400.0
Piping L_i Shutters
ers D Generator
SFt. of First Floor: _
Utilities:n Sewer 0Septic
F]Windows/Doors
11 Roof O Roof pitch
Building Height:
OWNERAESSEE:
CONTRACTOR:
Name
Name: i
Pi
Address: � 3 QNl �•
y
Company: e- r �Imin
City: &L Eae. State: f�'
Zip Code: 3"5l Fax: � J A
Phone N450 p
Addres/ss: X10 A T.lfh iICO
City. i50(t A tfff, State:
Zip Code:-��i11a5J( Fax:`I7a-4CIb-3131
Phone No.7+ li-- l4fy(�141
E -Mail: 01A
FII in fee simple Title Holder on next page (if different
from the Owner listed above)
E -Mail:
h `o ace- Q& 1 y . corn
State or County License: 0-A 1$i318(o
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.