HomeMy WebLinkAboutWilliams AC Change out permit app pg 1 001ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: i 2 21 Permit Number:
offifflemang
® Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-15S3 Fax: (772) 462-1S78 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: r
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Legal Description: J1AWArtn 1 iin i(! -unit 5 � l� y g W �`a �
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PropertyTax lD #: I'm i W s (),ZW -DOD - `'
Lot No.
Site Plan Name:
Block No.
Project Name:
Setbacks From Back: Right Side: Left Side:
DETAILED DfSCR(pnoN Of WORK'
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SON 1i4FORMATICIN: a aPP Y-
co>�s Ru un er t Is peI'md— c e
ne
❑Windows/Doors
Wor to a orme _Shutters
ItI a ❑Gas Piping
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Gas Tank
}{VAC t -1 p0Generator
Srinklers
f`1 n plumbing . 11,.,,1.
Roof
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Total Sq. Ft of Construction: Utilities: Sewer Septic Building Height:
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Cost of Construction: $ CQNTRACTOR:
City- Fax:------- —
Zip Code: 3 5�� --
Phone No-,
E_Mail: next page ( if different
Fill in fee simple ride Holder on
from the Ovuner listed above
If value of cOnstruction
Name: It
company, iQ l tI - ---
Address: state: �
Elp Cod (�12�G2/ Fax.-71 3
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Zip Coder 5 � -_-4
Phone NO-
E-Mail:
State or Cou�e:
a RECORDED Notice of Commencement is required.
or more, _