HomeMy WebLinkAboutKurth AC Change out permit app pg 1 001ALL APPLI BL INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 51-7 IZO Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce Ft 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 IMPROVE11IIENT LOCATION:
Address: f CQ 3((Q5I
1,,
Legal Description: - n1 IuS pouai r i (1 h
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Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
LiIcQ �D( GICC- ytnsigl hey 3 bn; (� s� Ruu,D ►�c[� un't
wow to VW Kk&-
CONSTRUCTION INFORMATION:
rti a war to rmed under this permit- crieck all apply-
HVAC Gas Tank ❑Gas Piping (�_j Shutters F]windows/Doors
-
0 Electric Plumbing Sprinklers L k Generator O Roof
Total Sq. Ft of Construction: Sq� Ft. of First Floor:
Cost of Construction: S-.�'l00.60 utilities: l_ISewer OSeptic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name fYIe; Y
Name: _
Address: lly ire(boIIS d(+-2
Company:
�.
City: State:,R—
Zip Code: 3LA 51 Fax:
Address:�I� i+ Cfr# It
Gty: I of f I7fP(GPi State: R_
Phone Nos% -131- 4b1q
Zip Code: '3+q 5 1 Fax: 7N, L4 y - 373-7
E -Mail:
PhoneNo.-rl,;L- 4-f11I-414'1
Fill in fee simple Title Holder on next page (if different
E -Mail:
State or County Licen e: CA -C 18181 zu
from the owner fisted above)
if value of construction is $2500 or more, a RECORDED Notice of Commencement is required.