HomeMy WebLinkAboutPulver AC Change out permit app pg 1All APPLICABL! INF? MUST BE COMPLETED FOR APPLICATION TO BE ACQ;PTC:D
Date: ~~2-1t-2-\ Permit Number: ______ _
COUNTY ---Fl OR ID i'\
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
Address: _!JOO:;}.JµLLJ....1,...L.,,..,.._t~~J..t!.1k.-f-'~~4'fl,b2.!.._I _________ _
Legal Description: __::::.-i:-""'-'.:.::..:...:.....c=c_.:;__:...:..:.....:....::::...4>r-_________________ -"/'--
Property Tax ID#: _______________________ _ Lot No. ___ _
Site Plan Name: _______________________ _ Block No. __ _
Project Name: _______________________________ _
Setbacks Front ____ Back: ____ Right Side: ____ Left Side: __ _
as Piping
□Electric 0 Plumbing Osprinklers
Shutters
□Generator
D Windows/Doors
ORoof
Total Sq. Ft of Construction: ______ _
Cost of Construction:$ 52{)0 • O()
S'}!!j of First Floor:
Utilities: USewer □Septic Building Height: ___ _
C01"TRA.CfOR:
Name:
Address: (Jtal 5 Ula Cf·
City: f&f Plm:t
Zip Code: ,3(\45l Fax: ______ _
State: i::t,
Company:
Address:5~/U/D~PrLJ@f@k±'!4at::~'&..___:__
City: f'orb' Pi'l(Q,, State: R-
Phone No. 1!:>J-JLk(,• 08H Zip Code: 3 415 I Fax: "11.:L-L{l,4,-373.1
E-Mail:. ______________ _ Phone No. 11:!-___,tU_q.._l_-~4_,_14:~f ______ _
FIii In fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail:\)Dy(eac {) ':,/l' boo. c.o cY1
State orco\mty Licenk; c.Ac, 1 '8 I '31-a lp
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.