HomeMy WebLinkAboutSeams AC Change out permit app pg 1All APPLICABLE INFO MUST BE C0MPl.ETED FOR APPUCATION 10 DE ACCEPTED
Date: ~ l I £l I 2., I Permit Number: -------
COUNTY ......_
l'LOR!OA
Planning and Development Services
Building and Oxle Regulation Division
Building Permit Application
2300 Virginia AW!nue, fort Pierre FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial ---Residential ----
PERMIT APPUCATION FOR: To Select from dropbox, click arrow at the end ot line
~e~~~tf4'tmtAnot,t~ · ·.·-. · ·;·---~~--:----:----:-----,,,.--,,--~.,.,.._.,,.,..,,.__
Address: u-v-~vi "l. ,3L/q5/
Legal Description: Sfa,'\.ISV) Lcd:.tS CoM:f!J6 ~Lib
PropertyTaxlD#: _____________________ _ lotNo. __ _
Site Plan Name: _____________________ _ Block No. --Project Name: ____________________________ _
Setbacks Front~--Back: ___ Right Side: ___ Left Side: __ _
Gas Tank
□Plumbing
penntt-c
Piping
Osprinklers
_Shutters
□Generator
0 Windows/Doors
□Roof
Total Sq. Ft of Construction:______ ~ of First Floor:
Cost of Construction:$ 4167) • ob Utilities: USewerOSeptlc
Name
Address.--"'-..,,__,,'-=-'='--"'~--'..:-""-""""--------
City: Hrt.e.. State:rft-
Zip Code: 3~~1 Fax:~------
Phone No. 1:J;l • ,;uiq " ~ 2 ~ E-Mail: _____________ _
Fill in ft!e simple Title Holder on next page ( if different
from the Owner Hsted above)·
Building Height: __ _
Name:
Company:
Address:5f0 Pr
City: ttJfb M'lfc.e,,, State: Fl..
Zip Code: ·3lf:95 l Fax: 71.:Z.·J.!l,fp-3]~1
PhoneNo.::tli-LJ.lol-414-f
E-Mai1,boyieac.::t;J,oo. C.o tD
State or County u : c.Ac, 111 I'S I a {f
If value of <:ORS1ruction Is $2500 or ,_.., a R£CORO£D -... of c:omn-cement is required.