HomeMy WebLinkAboutWood AC Change out Permit App pg 1 001ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5[l D I Irl��yyPermit 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) 462-1575 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: b5
Legal Description:f-
- 9,1 k 141 1n -r I (
Property Tax ID #: 1';0(,- 500 — 011-8 — 000 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
*dl r1 W Luthon .3 iovt 14 SEEK Uea — Puffl
5 KW &, L af heat
CONSTRUCTION INFORMATION:
LJHVAC Gas Tank L_fGasPiping L_JShutters
11 Electric Plumbing L_JSprinklers 01 Generator
Total Sq. Ft of Construction,++:�
Cost of Construction: $ K200 , 00
Sq �Ft. of First Floor: _
Utilities: U Sewer 0 Septic
❑ wlndows/Doors
nRoof
Building Height:
OWNER/LESSEE:
CONTRACTOR: -
Nam All
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Address:: Sqs N U F.VO L(4ps
Name: 2
b
Company:
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City: YgIG Pi we, State-_
Zip Code: gi-IgS I Fax:
Phone No. -72-41q - 1931
Address: 5101& rtwmptku
_
Freda K4
City: �P P?Pyu.
Zip Code: _i4qs (
Phone No�.'17 2 -061- X41
State: u
Fax: -17a4* -v s-7
X11
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
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E -Mail: W glex, O 'Sl"(0
- MO
State or County License.
CACl81$I$ (P
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.