HomeMy WebLinkAboutWhiteman AC Change out permit app pg 1All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5 {;l.til). \ Permit Number: ______ _
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia A11e11ue, Fort Pierce FL 34982
Phone: (n2) 462-1553 Fax: (n2) 462-1578
Commercial -----
PERMIT APPucAT1ON FOR: A C. Chah ou..:t"
PROPO
Site Plan Name: _______________________ _
Lot No .. ___ _
Block No. __ _
Project Name: ______________________________ _
I DETAILED DESCRIPTION OF WORK: ' f
Io kw htol:-I
New Electrical Meter ____ Second Electrical Meter _____ _
I CONSTRUCTION INFORMATION:
A~nal work to be performed under this permit -check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Pond
Electric _Plumbing _Sprinklers Generator Roof ____ Pitch
Total Sq. Ft of Construction: ______ _ Sq. Ft. of First Floor: ________ _
Cost of Construction: $ 4 i DD, QO Utilities: _ Sewer _ Septic Building Height: ___ _
OWNER/LESSEE:
Name 0(. \
Address: ~ l O.(p()f, l).e,/ No r{-e..,
City: tQ{-t' i) ( it[ IT. State: Pc,
Zip Code: 31.\qS I Fax: ______ _
Phone No. 2,{,J <7116 ~ ~1{,).
E-Mail:. ______________ _
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name:_Mi'lcn~_t~~'Jt.. _______ _
~~;::,v=~~~=tf{t ~~~~ ,lrx:.
City: &it J>«t[{l.. State: R.,
Zip Code: WI Fax: 1]2-4:,/r 3137
Phone No 11:k:Llu I• '-I lll-)
E-Mail YJoyt,.{A{l. @-'-('W°" • /In rr)
State or County License CAf! I j I it '8 (,
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.