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HomeMy WebLinkAboutSmith AC Change out permit app pg 1 001ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: -7 l 1,+) 2-0 Permit Number: Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 V/ Phone: (772) 462-1553 Fax: (772) 462-1S78 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION: Address: 94140 Silt{ Law, W ft Nat . 34Q45 Legal Description: Property Tax ID #: -,IL 1 I - O0�5 4 0001,5 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: L�Io_ �r [aka-. �K6-faf( nW 3.5 fort 14 sEEC pq"� t �ii f2Ul�tD (vri�► 10 ku) � 6at . CONSTRUCTION INFORMATION: 0 HVAC U Gas Tank Electric 0 Plumbing OSprinklers Gas Piping HShutters ElGenerator Windows/Doors Roof ❑ Total Sq. Ft of Construction: r Sq. Ft. of First Floor: Cost of Construction. $ `f OQ o • o O Utilities: 0 Sewer 0 Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name Name: Addrests�: I 315+ Company: C'Miji City Statc EG Zip Code�_3.3 6(tq Fax: Phone No:ttviant.SrY11 IA Addrefss.5 f7 City. i U(�i I fe(Z State:_ Zip Code: '3 i f5i f! Fax: ?7�- 416 9 -373` 1 PhoneNo,`",�-- tD(-41-4-1 l• i) E-Mai-'1 (Lygq Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail:. ci (ri State or County Licen e: C Q, I 1813 IQ •• ••••-- �• •� r�+o...+. •••.,�r, .. ncw�c�cu •vouce or,-ommencement is required.