HomeMy WebLinkAboutEngman AC Change out permit app pg 1 001NUL APPUCA LE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
'Em_. 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 III
PROPOSED IMPROVEMENT LOCATION:
Legal Description:
Lf o r (oTs l * i, 15
Property Tax ID#: 11I -WS -001"0_25 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
b4 -CD( U vt. ):;�stgU 3 ion !(Q S,5rIz Lehrlox sf
S45 -fun WRh [OKU) head
CONSTRUCTION INFORMATION: `
Mortal work to bepertormed under this permit- check all apply:
UV HVAC I I Gas Tank
0_ Electric 0 Plumbing
Total Sq. Ft of Construction: 1 I
Cost of Construction: $ A-400 _00
]Gas Piping Shutters ❑ Windows/Doors
ORoof
ers II Generator
Sq. Ft of First Floor: _
Utilities: [J Sewer 0 Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
Q
Q
Name: �
Address:_szo� Grow(rl st,
Company: 0VAg Airil)Yk�ii,Viia� HPp4q;itE_._.
city: Jip9 -r l ((Q State: P�
Zip Code: �y!(�J t`1 Fax:
Phone No. �lpaLf7%-}(�g�
Address: 510 6 Pr TU,t't'1OfkA- jjP
City, fb(-& RtrCPi State: f5t_
Zip Code: '3"51r Fax: -7l.?-- 0-313�j
PhoneNci.-ril_
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail:AVo. Ca (n
State or County Licen e: G4C ($ I
n value of construction is 4.zsuu or more, a ntcunutu Notice at commencement is required.