HomeMy WebLinkAboutBianchi AC Change out permit app pg 1 001ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
-
Building Permit Application
Planning and Development Services
/
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 J
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:
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Legal Description:
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Property Tax ID #: �I ' L3 - 025 ' b�0 QQ '� Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: LeftSide:
DETAILED DESCRIPTION OF WORK:
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CONSTRUCTION INFORMATION:
iti a work to e e orme un ert ispermit—checka appy:
LJ ❑Windows/Doors
HVAC Gas Tank Gas Piping _Shutters
Electric 0 Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S Ft. of First) FFllojor:
Cost of Construction: $ OO. DO UtilitiesSewer L )Septic Building Height:
OWNER/LESSEE::
CONTRACTOR:
Name
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Name: kl6tltAt
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City:
Zip Code:,3Lfg6I F'ax1:1
City: fbril -Remo,, State: �L
PhoneNo.77.1-�Q- N34
Zip Code: "3 5I Fax:���'�1(nlp-3T3i
E-Mail:
Phone No.
Fill in fee simple Title Holder on next page ( if different
E-Mail:6Dq kn0. 0 A (Y1
State or County Licen e: cAe' l8 I S ($ Ip
from the Owner listed above)
If value of construction is $25f10 or more, a RECORDED Notice of Commencement is required.