HomeMy WebLinkAboutONeil AC Change out permit app pg 1All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 51 I 1 / 2. I Permit Number: _______ _ t I
Building Permit Application
Planning and Development SeNices
Building and Cnde Regulation Divisian Commercial Residential _v' ___ _
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: {772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
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Address: __ ,:g.if9---l__.,-4->LL!J..__,....L._.__~__,w.c_,___~-'--'-'-"--':.+--___.__-=---=C-..!._._5=--------------
Property Tax ID#: 13o~ -£00 4 0lt,({p ~ooo-;;i,,., Lot No. ___ _
Site Plan Name: ________________________ _ Block No. __ _
Project Name: ________________________________ _
DETAILED DESCRIPTION OF WORK:
New Electrical Meter ____ Second Electrical Meter _____ _
I CONSTRUCTION INFORMATION:
A~onal work to be performed under this permit -check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
Roof
Pond
Electric _Plumbing _ Sprinklers Generator ____ Pitch
Total Sq. Ft of Construction: ______ _ Sq. Ft._of First Floor: _________ _
Cost of Construction:$ 52.QO.0O Utilities: _ Sewer _ Septic Building Height: ___ _
OWNER/LESSEE:
Name->-.Jwu.._...,.._..~.._..4-________ _
Address: I Lj H,J C is ne. C ( rr le,
citv: AA 1?1u:c.t State: ft
Zip Code: ~I Fax: _______ _
Phone No. ______________ _
E-Mail: ______________ _
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name:__._.....,.,,.,_.__,"'-'"""',-,....~--------
Company: &\111.. Nr ~~ ~ Mta~ ,:Tut.
Address: 511lS~lfAA?ll£ f.udzf"J¼{.
City: 11)(t Piu:ce.. State: /:t,.
Zip Code: 3':J4!,I Fax: 1]2,-µ/,u-3137
Phone No 11.'.k:':lu I· l-114 I
E-Mail boyt1,.rul !,'f4'boO. 11J}(Y\
State or County License CACI jl-SI g (p
If value of construction is 2500 or more, a RECORDED Notice of Commencement Is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.