HomeMy WebLinkAboutPerry AC Change out permit app pg 1 001ALL APPLICAPL4 INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
m - .
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: Q
Legal Description:
Property Tax ID #: _1312- 500- 0073- D 0$ Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: _ Left Side
DETAILED DESCRIPTION OF WORK:
INFORMATION:
LIHVAC L JGasTank [JGac
Electric 1:1 Plumbing ospi
Total Sq. Ft of Construction:
Cost of Construction: $ �4500. Dd
nit — cnecKall apply:
Piping _ Shutters
nklers 0 Generator
_ 5 Ft. of First Floor: _
Utilities: 11Sewer Septic
Windows/Doors
ID Roof
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name`�niyil1d �ynA
Name: f
Addre 0 r
Company:
£
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City: [IJ�j Yl�(CQ Stater
Zip Code: SLR5( ' Fax:
Phone No. L4. 1 f 1A- ✓ 210
Address:5,Id A TLL(rl
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City: YUfb"f (ef(&
Zip Code: S+q 511�
Phone No.-111-
State:_
Fax:-77X-G{&-3]3'j
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail:i�/1 qA hOp.
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State or County License:
ChC 1818I $
.. ramc V. wn>uucuun is ;lOOu or more, a 11MUKUM iVOtite Or C:ommen6ement is required.