HomeMy WebLinkAboutRichardson AC Change out permit app pg 1 001ALL APPLICABLE INFO MUST BE COWLETED FOR APPLICATION TO BE ACCEPTED
Date: ., ?�Zo __ Permit Number:
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 349x2
Phone: 1772) 462-1553 Fax: (772) 462-1578 Commercial Residential V
PERMIT APPLICATION FOR:
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'PROPOSED IMPROVEMENT LOCATION- �I
Address:
Legal Description:
Property Tax tD #: 230 `'y Z 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:
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n_ HVAC GasTank �Gas Piping _Shutters Q Windows/Doors
LJFiectric Plumbing Sprinklers cienerator ElRoof
Total Sq. Ft of Construction:
cost of Construction: $ O oo. oo
Ft. of First Floor: _
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Building Height:
OWNERILESSEE:
CONTRACTOR:
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Address: 7O 3(Sf Qi
Name: WcAd9i
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city:�0M4NIVID State:�
Zip Code: 3 Fax:
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Address:5l06J -a,irYlAk- a W
City: Y -b—i Re-rC& State:
Zip Code: '3 51 Fax:'7?X-4WR-313`1
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>-Mail: 515 -141- RD-41A-1Phone
Fill in fee simple Title Holder on next page (if different
from the owner fisted above)
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State or CosrMy Licenle: CACI 8l8 i-8
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