HomeMy WebLinkAboutMalone AC Change out permit app pg 1 ALL AP LE 1rJF0 MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number-
s
Building Permit Application
Planning and Develbpment5ervkes
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce F!34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To SeW from dropbox, click arrow at the end of tine
Address• C Jr-
Legal Description; �W
Property Tax ID#: Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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Mot Mh tO 6�Jw ,
Additi al work to e.pgrrormed under mis permit checK a apply:
HVAC Gas Tank ❑Gas Piping OGenerator
Shutters Windows/boors
Electric Plumbing E]Sprinklers Roof
Total Sq.Ft of Construction: Ft.of First Floor:
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Cost of Construction:$ `� Q a0. utilitiesSewer OSeptic Building Height:
1
Name = dGtir'1 Name
Address:
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City: t' A_ Ip f ffct State: w Addresss: ��J,4
Zip Code: 3l S I Fax: _ City;fba RtLcg� State: �L
Phone No. -1a8. 3322, Zip Code: 3 4q 5 } Fax:-T?-'L-LUPO.373VI
E-Mail: Phone No.7TI3.- !Hof ,-4111
Fill in fee simple Tide Holder on next page if different E-Mail:
from the owner listed above) State or County Licen e:
If value of cwtaruction is$2500 or mare,a RECORDED Notice of Cornnumcenemt is required.