HomeMy WebLinkAboutSten AC Change out permit app pg 1 001--------------
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1(181w-- Permit Number:
0
ON
Building Permit Application
Planning and Development services
Building and code Regulation Division /
2300 Urginia 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: 0 C
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Legal Description: La6woo
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rg,! LtVIYI 11 - Sty-
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I3q LOT' 33
Property Tax ID #: 'I 3Q1 00 `000 -o Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
bl a- for t,(ce: J(ii [l rew a.5 +w 14 S¢tr I mju Sell+
�tL sgs+trV1 wi h 10 0) NO
CONSTRUCTION INFORMATION: ,
iti a wor to e e orme un eri ispermK-c ec a apply:
HVAC ❑Gas
_ Gas Tank Piping _ Shutters M Windows/Doors
Electric Plumbing 11 ❑_
Sprinklers Generator Roof
Total Sq. Ft of Construction: S Ft. of First Floor:
/-ern
Cost of Construction: $ 3M.0d UtilitiesSewer Septic Building
Height:
OWNERAESSEE
CONTRACTOR:
Name
Q(
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Name:
Address: 5q03 Ki la(ii
_
Company:
Address:5(0 r'} Tjrhpik.9-�
City: 1'ror Nwe State: i.
Zip Code: 3 L}[{ Fax:
City: (arm ' state: L
Phone No. 7'( 7. -,577 —1(e (07 '
Zip Code: S 49 5 1 Fax: -71a 1Qp(-373
E-Mail:
Phone No.- 7` 9- q{R( _ 41 i -1
Fill in fee simple Title Holder on next page ( if different
E-Mail:�Q0. on r►'1
from the Owner listed above)
State or County Licen e: CkC 181 S I B (p
If value of construction is $2500 or more, a RECORDED Notice of Commencement
is required.