HomeMy WebLinkAboutNieves AC Change out permit app pg 1All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: {i / 4:J :Z..I Permit Number: _______ _
t /-
Planning and Development Services
Building and Code Regulation Division
Building Permit Application /
Commercial_____ Residential ____ _
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Ale, Cktan _t)kl-
Address:
Property Tax ID#: l3Q( •'°1 • i0033 • 00 -Lot No .. ___ _
Site Plan Name: _______________________ _ Block No. __ _
Project Name: ______________________________ _
I DETAILED DESCRIPTION OF WORK:
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:$ 51-00 • 0 0 Utilities: _ Sewer _ Septic Building Height: ___ _
OWNER/LESSEE:
Name,~&a..!L<!..l6<'....,.,J~'..!!=.l~~------
Address:.---1J.JJ.~__\,,,U.L.'!!>JL.[..lh!~~=.::._---
City: 112rt: Piure, State:
ZipCode: 3L¥t51 Fax:. ______ _
Phone No. 3y1-'31')..-f.l&7q
E-Mail:. ______________ _
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name: Mithul , &y/e,
~~;::~:J~-t~~~~~~ ~
City: nit Piure.. State: R.,
Zip Code: 3'ftSI Fax: JJ:J.-df,r,-37 37
Phone No 11l---L¼C. [ • Lt 14-I
E-Mail boyt1.GW. @,'-('WOO. f'OQ'\
State or County License CACI jf'i111J (p
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,SOOor more, a RECORDED Notice of Commencement is required.