HomeMy WebLinkAboutSanders AC CHange outALL APPLICABLf INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Ia khq 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:
Address: _I n �)
Legal Description:
Property TaxlD#: 3t� I-5 � �23a-Doo-,3 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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CONSTRUCTION INFORMATION:"
rti a workto a orme under -ti -checkppermit a apply: XHVAC be
❑Gas Piping In _Shutters Windows/Doors
11 Electric Plumbing �Spr
Total Sq. Ft of Construction:
Cost of Construction: $ 3 20Q. 00
ors 0 Generator
S Ft. of First Floor: _
Utilities:n Sewer E]Septic
0 Roof
Building Height:
OWNERAESSEE:
CONTRACTOR:
Name
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Name:
Address:
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Company: (
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City: Fb(t Pitac State:_
Zip Code: 3LIcf R ( Fax:
Phone No.
Addresss:5ld 6 1+IfnOi(u-
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City: Font RefcP
Zip Code: S41 51
Phone No.-"g-- 4Y01-
State:
Fax: -71-2--460-3]3'j
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E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail:
State or County Licen e:
ClkC I Z 1313
R value of construction is SZ500 or more, a RECORDED Notice of Commencement is required.