HomeMy WebLinkAboutKabasan AC Change out permit app pg 1 001ALL APPLICA LEE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
o �
Building Permit Application
Planning and Development Services
Building and Code Regulation Division /
2300 Virginia 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 III
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description:
Property Tax ID It: 1301405, 0 31-1- 0 00 - q Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
RETAILED DESCRIPTION OF WORK:
UkQ, For j�,StOAj n io Law 3 -b j 14.5 SEE .
5�5,�t ni With 10 Kul hee.
I' CONSTRUCTION INFORMATION, jI)
�1T.7it„F.ol .u,.rL I- .rfnrmn nn r t ncrmh _ r or � I It of nnn �r
Gas Tank
❑Gas
Piping
U Shutters
F-1 Windows/Doors
El
Plumbing
OSprinklers
U Generator
O
Roof
Total Sq. Ft of Construction:
Cost of Construction: $ 41'00. DD
Sq. Ft. of First Floor:
Utilities: 0 Sewer D Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name
(r1VliS
Name: WhM
Addresss: 42, TOt7-i06-Oyl / �
1111,�,
Company: L2b� Q ri
Imo'"A
(wit thiyiela �iPCL�'lilGrTrIC.
City: �,f4Lke( State: h(G
Zip Code: 3 �J? Fax:
Phone No. KAS•dgt)-2392
Address:5(d�*_f6-
City: f �(QJGp�
Zip Code: S4951
Phone No. -"I�- !YAf
State: �
Fax: _712--4&0-373i
-414-
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail:
State or Co my Licen e:
UcC t S I S I B (P
If value of construction is $2S00 or more, a RECORDED Notice of Commencement is required.