HomeMy WebLinkAboutCovello AC Change out permit app pg 1ALL APPL~ INFO MUST 8E COMPLETED FOR APPLICATION TO 8E ACCEPTED
Date: :l2!t 2-\ Permit Number: _______ _
COUNTY ---.....__
F'l0R10.A
Building Permit Application
Planning and Development Services
Building and Code Regulation Dillision
2300 Virginia Avenue, Fort Pim:r FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial ___ _ Residential __ / __
PERMIT APPLICATION FOR: To Select from dropbox, dick arrow at the end of line
PropertyTaxlD#: ______________________ _ lot No .. ___ _
Site Plan Name: ______________________ _ Block No. __ _
Project Name: _____________________________ _
Setbacks Front. ____ Back: ___ Right Side: ___ left Side: __ _
1 · DETAltEO pES~lPl'IDN OF WORK:
CONStRtiCTION•lNFORMATlON:
Gas Tank
OPlumbing
un
sPiping
Osprinklers
hutters
□Generator
Total Sq. Ft of Construction:_______ ~ of First Floor:
Cost of Construction: $ L¼'oo . 00 Utilities: USewer □Septic
OWNER/1.£SSEE:
Name {"/k'jW: t'!:L,m,, ld(,c..-VU I 0
Address:'14 l.l.lgos 1>.t I Wori-~
City: tr/ft: p ll( (L State: 1=<...,
Zip Code: 3qqs I fax: ______ _
Phone No.TI+◄ 14(e0-tftT&
E-Mail:_-_____________ _
fill in fee simple rltle 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 Conm1e11c.ement is required.