HomeMy WebLinkAboutTallant AC Change out permit app pg 1All APPU~BLE INFO. MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date{pJ.-8 I 2-I Permit Number: _______ _
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I' Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial ____ _ Residential_✓ ___ _
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT lOCATlON:
Address: (pSOS ?1/1 SIMO~ r fo ( t (.lie e, , 31.fqS" I
PropertyTaxlD#: /30/ -~/J. -001() • 000-7 lot No., ___ _
Site Plan Name: _______________________ _ Block No. __ _
Project Name: ______________________________ _
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 Pitch ----Generator Roof
Total Sq. Ft of Construction: ______ _ Sq. Ft. of First Floor: ________ _
Cost of Construction: $ L\ 8 00. 60 Utilities: _ Sewer _ Septic Building Height: ___ _
OWNER/LESSEE:
Name (, 1i
Address: <osos Pt/1.Stl (.D[t,y
City: fo(f; 1)( Q({-l State: 0.-
Zip Code: 3i.fi:i'5 I Fax: -------
Phone No. <toll-::,-:,t}-.;>q5'1
E-Mail:. ______________ _
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name:...u:'u.u.oc.i......!.o....i,"'-1-&<.--------~:;::~:~~-:n~zr~~~ ~
Oty: 11)(.f;-Pivce... State: R,
ZipCode: *' Fax:JJ:i-lf,r,-3137
Phone No11l,-:Llul-'4141
E-Mail 'coy111.<Ml @, '-('WOO. Pn(Y\
State or County License CACI ZI 'ill 3 (,
If value of construction is 2500 or more, a RECOROED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.