HomeMy WebLinkAboutMcIntosh AC Change out Permit App pg 1 001ALL APPL CAB L/E�INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: D fq Permit Number:
Building Permit Application
Planning and Development Services
Building and Cade RegulationDivision /
2300 Virginia Avengue,,FortFort 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 (�)
I�PROPOSED IMPROVEMENT LOCATION:
Address:
Legal De:
Site Plan Name: �—
Project Name:
Setbacks Front Back:
Right Side: - -_ Left Side:
DETAILED DESCRIPTION OF WORK:
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bJl�h to KO) hear.
Lot No.
Block No.
CONSTRUCTION INFORMATION;
AdditiAal work to e
e orme un ert
ispermd-c ec
a pp
_ HVAC Il
Gas Tank
Gas Piping
_
Shutters
Q Windows/Doors
11 Electric ri Plumbing
Sprinklers
EJ Generator
o Roof
Total Sq. Ft of Construction:
S Ft. of First Floor:
Cost of Construction:$ 3960.60
Utilities:
0
Sewer
0Septic
Building Height:
OW NERAESSEE:
CONTRACTOR:
Name
I
E
Name:
Address: �nn(�
5t'
Company:
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City:T% I�(1/n,0 t')QtXIV� State:rSC
ZipCod�MQ(09 Fax:
Phone No.
Addrefss:��1(((�Vr� ..
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city:00(-b- (QfCei State: R,
Zip Code: S 4q 5 1 Fax: -I ?;-- 4& -373`I
PhoneNo.-T19- q(t(-4IkJ
E-Mail:
Fill in fee simple Title Holder on next page ( ff different
from the Owner listed above)
E-Mail:
State or County License: CAC, I'S IS 1'8
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required.