HomeMy WebLinkAboutTiganila AC Change out Permit App pg 1 001ALL APPU ByLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: J In 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
PROPOSED IMPROVEMENT LOCATION:
, /� •.' ". ' it 1_ - T. i.:.nif
Address: (of _I A
Legal Description:
Property Tax iD #: 13I), "Sol " 00 3$ - 000 - 4 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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CONST UCTION INFORMATION:
rt na wor tc e e orme un er t is permit — c ec a app y:
HVAC 1:1 Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
11 Electric 0 Plumbing ❑Sprinklers 1:1 Generator E]Roof
Total Sq. Ft of Construction:( Sq. Ft. of First Floor:
Cost of Construction: $ 00 Utilities: 0 SewerEl Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name ir I cAani G(I
Name: I&
Address:- b �L S v_ W 0
Company: f3OV le 0 dIJ I �I (1YIInGt
City: )(P�ff, J State: Pt'
Zip Code: 31 IQ5 ( Fax:
Phone No.
Address:
City: State:_
Zip Code: Fax:
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page I if different
from the Owner listed above)
E-Mail:
State or County License:
If value of construction is $7S0O or more, a RECORDED Notice of Commencement is required.