HomeMy WebLinkAboutMontella AC Change out permit app pg 1All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: :3\5JU PermitNumber: ______ _
COUNTY --...._
fLORIDA
Building Permit Application
Planning and Development Services
Building and Code Regulation Divisian
2300 Virginia Avenue, Fort Pierre 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
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PropertyTaxlD#: 2.;$03-1:11 -001-5/(}00 /S I J
Lot No., ___ _
Site Plan Name: _______________________ _ Block No. __ _
Project Name: _______________________________ _
Setbacks Front~---Back: ___ Right Side: ___ Left Side: __ _
s permlt-c
Gas Tank Qas Piping
D Plumbing Osprinklers
Shutters
â–¡Generator
D Windows/Doors
ORoof
Total Sq. Ft of Construction: ______ _
Cost of Construction:$ J.+400. 00
~ of First Floor:
Utilities: USewer D Septic Building Height: ___ _
Name
Address: &+-
City: 'Pam ft",11 O f31Arh State: /tL
Zip Code:33Qc', 1'.f Fax: _______ _
Phone No. tJY1a,,1f; Jo 5/lf b M/f'yrkl/().;
E-Mail: 112 -,). IJ-2. -x' 3 I I?
Fill in fee simple Title Holder on next page ( If different
from the Owner listed above)
Company:
Address: 5( 0 Pr
City: tOfb" H'e(c.e,, State: Pc...
Zip Code: ·31.f:ll 5 J Fax: 71.:Z..·'-tl,,fe-373,
Phone No.11:J.-%,(-414:1
E-Mail:~leac e f boa. Corn
State ore::nty licen:; e.Ac ti I '8 I -a (p
If value of construction is $2500 or more, a RECORDED Notice of Commencement Is required.