HomeMy WebLinkAboutOrtiz AC Change out permit app pg 1ALL APPllCABlE INFO MUST BE COMl'lfTfD FOR Af'PUCATION TO Bf ACCl:PTED
Date: .5\10[2-1 Permit Number: ______ _
COUNTY ---..._
FJ..ORrD.A
Building Permit Application
Planning and Dew,Jopment Services
Building and Code Regulation Division / 2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (7n) 462-1553 Fax: (7n) 462-1578 Commercial Residential --------
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Property Tax ID#: -i-~ I 0 -soo ~ 0[<,fLf -000 -4 lot No .. __ _
Site Plan Name: _____________________ _ BlockNo. __
Project Name: ____________________________ _
Setbacks Front. ___ Back: ___ Right Side: ___ Left Side: __ _
C Gas Tank as Piping
□Electric D Plumbing Osprinklers
utters
□Generator
Total Sq. Ft of Construction: --=------~ of First Floor:
Cost of Construction: $ 4-q 00 • /JO Utilities: LJSewer l !Septic
OWNElVl;ESSEE:
Name I
Address: \S:~ Ot Ch):HQ TX
City: fo ?l:: Vftl c..-e_ State:.'fv
Zip Code:i.fq L-15 Fax:~--=-----
Phone No.~q-~~LJ.--.1 l_e...,......Ll~q~,._t_O~S~Cf~----
E-Mail:. _____________ _
Fill in fee simple Title Holder on next page ( if diffd1!tlt
from the OWner Hsted above)
If value of QfflstnKtion is $2500 or more, a RECORDED Notice of Commencement is ,_;red.
□ Wmdows{Doors
□Roof
Building Height: ___ _