HomeMy WebLinkAboutResmond AC Change out permit app pg 1 001kU. APPLI BLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7-0 _ 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: -7alXl 3415
Legal Description: LA ktWO0 LkN if 3 - (3tk $ LoT Z°!
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PropertyTaxlD#: 1301- 0?)-DO-QQ�_jo 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:
CONTRACTOR:
Name
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all apply:
Address:
HVAC Gas Tank
0
❑Gas Piping
In _Shutters
❑Windows/Doors
Electric Plumbing
Sprinklers
FIGenerator
0 Roof
Total Sq. Ft of Construction:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
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S Ft. of First Floor:
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Cost of Construction: S 5300. 00
Utilities:Sewer Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
Name:
Address:
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Company: 40)tL RI(
City: Of�1�1pX7P State: R-
Zip Code: 3'10,51 Fax:!f�
Phone No.11 A- 21 e2 7
Address:5106ATw-ni/co—�oP��—�,•L ''
City: YU�� �"Z1fC2i
Zip Code: .3 �f9 5
Phone No. -"%a._ 4Hkif-414-1
State:_
Fax: 77;-- 4&p 37 S-7
E -Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
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E -Mail:{ �/I ItA
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State or County License:
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