HomeMy WebLinkAboutVandell AC Change out permit app pg 1 001ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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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
PROPOSED IMPROVEMENT LOCATION:
Address: f 2 W I
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Legal Description:
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Property Tax ID#: VS - 5 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back_ Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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CTION INFORMATION:
or to e e o1 - un er t is permit - c ec a app y:
V�GasTank ❑Gas 11Windows/Doors
Piping _Shutters
❑Electric 0 Plumbing ❑Sprinklers ElGenerator O Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
(LEI 0
Cost of Construction: $ 3S Utilities: Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
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Name: l
Address: U% �� sr
Company: I � t)
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City: �nw11fA/Ann IXn11flI State:
Address: i�-(,(rtAkiL.1Jl� �
City: t'Uf �i �f P %C2i State: F_L
Zip Code Fax:
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Phone No. fV,[VA+-5hail7Y1 Ug�(I
Zip Code: '3 5E Fax:-7
E-Mail: q19- 3�5'- 1 / Y
PhoneNo.'711- Q-414-1
Fill in fee simple Title Holder on next page ( if different
E-mail: n han. 0-O (Ii
State or County Licen e:
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.