HomeMy WebLinkAboutScan ac change out 2AH APPLICABL INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date; zo i Permit Number;
Liu
IL
Building Permit Application
Planning and velopment Servir-es
8uffdingand Cc ideRegufationDivision Commercial
2300 Virginia A
Phone. (772)
venue, Fort Pierce FL .34992
62-1553 Fax. (772) 462-1578
PERMIT APPLICATION
FOR:
PROPOSED
IMPROVEMENT LOCATION:
Address: �!
Property Taxi
Site Plan Name
Project Name=
C
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DETAILED
—
6ESCRIPTIO OF WORK.,
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N TRLII ION iNFC3RMATION:
Additional work to be performed under this permit —check all that apply:
g4,Mechani I _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors Pond
_Electric Plumbing _Sprinklers Generator Roof Pitch
Total Sq. Ft of C onstruction, 54. Ft. of First Floor;
Cost of Canstru c6on: Uti lities; _ Sewer _ SF-Ptir Building Height:
OWNER/L §SEE: - ; , ...... [CONTRACTOR:
:: _
Name ,.. 11--�—
!Address: r 14 r-FaO C Cornpany: i4/t (OLej�IC'—
City; I rState: 6 Address: + 14-A C7
Zip Code: Fax: _ City; I��q Sta#e;
Phone No-4- � Zip Code: 1 Fax:
E Mail: Phone No z 2 40
Fill in fee simple Title Holder on next page ( if different E-Mail L.if 7� r-F, � (o , r
from the Owner listed above) State or County License CKC f
if value of con sti uction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAYC is $7,500 or more, a RE CORDED Notice of Cammencement is required.
Residential '
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Lot No-
---- Block No.