HomeMy WebLinkAboutWhitlock AC Change out Permit App pg 1 001ALL A-PPLWAiKE WREY AW51' BE COWLEyM FOR APPLICATION To BE
Date: 1 Permit Plumber_
Building Perinit Applicatim
Planning and Development Services
Building and Code Regulation Division
/
2300 Virginia Avenug Fort Pierre FL34482
Phone: (772) 462-1553 Fax: CM) 4624578 Cimmercial Residential
APPLICATION FOR: To Sept ffrorrl arrow at the end o€ line
P
Ei3 ITPROVEEIJT LOCATION:
Address: 54oa oo f-(' �Re q°(5
Legal Description:
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Property Tax ID #: t30 ('l 1 LL ' 0010. coo -.Is
Lot No -
Site Plan Dame:
Block No.
Project Name:
Setbacks Front Back Right Side: Left Side:
DETAILED DESCRIPTION OFWORK:
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CONS z RUCTION INFORMATION-'_
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Additighal work tobe Mriormedpenult— dieck ant= app
HVAC ]Gas Tank ]Gas Piping ]Windows/Doors
_Shutters
[J Elecisie I t Plumbing Ospr:r:klers 0 Generator F1 Roof
Roof pitch
Total Sq_ Ft of Construction:S . Ft. of First Floor:
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Cost of Construction: $ `'I -I. �, U� Utiktim- 0 Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Q
Name: N
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Address-. SLwa GQS{tiMAkUQ�
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Company: a0� r h �
City: l �1 G pi Q, aQ� State:
zip Code: '�qg5 ( Fax
Phone No.',11-
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Address: SOYA,
Criy: N- �imr e, State: Y�L
Zip Code: 3I-1q 5( Fax: 11.1
Phone No. 71 i- Ae (-L((l-( (
E-Mail:
Fill in fee simple Title Holder on next page I if different
from the Owner listed aWvej
E-Mail: /l (/IUD- C.
State or Co License: