HomeMy WebLinkAboutWyant AC Change out Permit App pg 1 001ALL APPLIC LE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �5 aD Permit Number:
Building Permit Application
Planning and Development ion Dices /
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 lI)
PROPOSED IMPROVEMENT LOCATION:
Address: 11 Udk
Legal Description:
Property Tax ID O���o1r(]���•O��-6 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
I,11CQ Yb� 64 ; 4ilsbd l 1 tV1 1(0 S66IZ LQrVWX S lit
545,t-tlm 'JUR11 5 Kc) heaVt-
CONSTRUCTION INFORMATION:
UV HVAC L =.1 Gas Tank UGas
11 Electric Plumbing ospr
Total Sq. Ft of Construction:
-
Cost of Construction: $ -ate 0 o
Piping "Shutters
ors L I Generator
S�Ftj. of First Floor: _
Utilities: LJSewer Septic
QWindows/Doors
0 Roof
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
Name:
T '
Address: 1(Qa, 1�f1.�.,,�j
Company:
yj� fi
City: �3&-J?jffuG State:
Zip Code: 34gsk Fax:
Phone No.
T�(,,,
Address: 3(d:1 PrTU,(rl)?iLUL �P
City:(-&—Refc.Pi
Zip Code: 13 � `5d ))
Phone No.-r19-
State: �
Fax: ??�- (F -373i
E-Mail:
Fill in fee simple Title Holder on next page t if different
from the Owner listed above)
E-Mail:
'(,o n
State or Co my Licen e:
CAcC 1818I
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.