HomeMy WebLinkAboutBluemel AC Change out permit app pg 1ALL APPLICABLE INFO MUST BE COMPLETED FOR APPUCATION TO BE ACCEPTED
Date: ?1/S/1-1 PermitNumber: ______ _
COUNTY ~
FLOR.lDA
Building Permit Application
Planning and Development Sentices
Building and Cade 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:--4!::L..Uc..:5':.....LU:!l~..J..U.e,L._~c!...,----!:l-ll.(..J.<...--WJ'"1..L~_...:::...!....!.5=-/ ----------
Legal Description:___,S .... ·?J-f\_,_,i><.sh'--'-1,L.,,.ab=~s'---'fa~,,~CW~CL__,,_~+=s~------------~-<~
PropertyTaxlD#: ______________________ _ Lot No .. ___ _
Site Plan Name: ______________________ _ Block No. ---
Project Name: _____________________________ _
Setbacks Front. ____ Back: ___ Right Side: ___ left Side: __ _
as Piping
D Plumbing Osprinklers
Shutters
□Generator
Total Sq. Ft of Construction: ______ _
Cost of Construction:$ it@O ,OO
~ of First Floor:
Utilities: LJSewer Oseptic
OWNEN:t.ESSEE:
Name.__,_,..,...,,,._..,._.L-'\Ai,J-U'-L-~...,_.,"-'-'-!<+-----
Addr~: ll.\2(05 Au1.t. Wft. e);.
citv=t'Dfu llirce... state,yt;
Zip Code: gW I _l;.i!x=~------
Phone No. {qo 3 ~ (/15 • 5 l J./-?-
E-Mail: _____________ _
FIii in fee simple Title Holder on next page ( if different
from the OWner listed above)
D Windows/Doors
□Roof
Building Height: ___ _
If value of construction Is $2500 or more, a RECORDED Notice of CommenQ!fl1ent is required.