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HomeMy WebLinkAboutYenchko AC Change out permit app pg 1 001ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ( Date: I I "�� 1 Im Permit Number: 4 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 III PROPOSED IMPROVEMENT LOCATION: III Address: Legal Description: V_ Property Tax ID #:.3+4 1 0 - 503 -02-S3-000-0 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: U 0- ib U Ja : S4 -<ix (tVtYIt7X 3 S '1 ( 4 S 1E WZ Nea+ 5f I& hlC tvii- wlfh 5(, -LJ 6ALt 4 hear. CONSTRUCTION INFORMATION: Of �ti nalworkto (eve orme under this permit- check a appy: HVAC L_I Gas Tank ❑Gas Piping _ Shutters E]Windows/Doors 11Electric Plumbing []Sprinklers Generator 0 Roof Total Sq. Ft of Construction: Cost of Construction: $ 0 - ©0 S Ft. of First Floor: _ Utilities Sewer D Septic Building Height: OWNERf LESSEE: CONTRACTOR: Name 2 Sq .(y rtd,6,G,- Ur. Name: WchadNr Company:Bn 6d& Nr dd t�yl�laa� City: I�yt pUf-co- State: 41, Zip Code: 3 44 ga- Fax: Phone No. Address�: 510 ffr-(,rrlli(k.0- Gyj_ )=nom City: I'U!F&—RtrC& Zip Code: "3 5 1 Phone No.-V,'�- State: Fax: -71.2-- 4&(a E -Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E -Mail: 6o-41w n0. nn (Y; State or County Licen e: CAcCI$ IxI 8 (!! If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.