HomeMy WebLinkAboutLewis AC Change out permit app pg 1All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Jh {2-1. Permit Number: _______ _
Building Permit Application
Planning and Develapment Senlices
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (n2) 462-1578
PERMIT APPLICATION FOR:
Commercial ____ _
PROPOSED IMPROVEMENT LOCATION:
Property Tax ID#: ________________________ _
Site Plan Name: ________________________ _
lot No. ___ _
Block No. __ _
Project Name: ________________________________ _
New Electrical Meter ____ Second Electrical Meter _____ _
[ CONSTRUCTION INFORMATION:
Ao/.'~nal 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:$,_L-\{g~Q_Q~,OO ____ _ Utilities: _ Sewer _ Septic Building Height: ___ _
OWNER/LESSEE:
Name--1,.,11.k!JILISol"'-::--'-""""-"ol.---,,;,--------
Address:_1=~.l.U..l.lleL:1.~..u,c::._ _____ ~_
City:nJ<h:PlercL-State:~
Zip Code: .3lfll'5 I Fax: _______ _
Phone No. q!:\Q-ll O I
E-Mail: ______________ _
Fill in fee simple Tttle Holder on next page ( if different
from the OWner listed above)
CONTRACTOR:
Name:..Miiinru.lc.J:J~'/i... _______ _
~:;::;~J~tn~tfg~~ ~
City: 112'-b-]>it(Cl.. State: l:t..
Zip Code: 'Simi Fax: JJ:i-J.f,t,-3137
Phone No 11),-L:K, [ • l-1 l4-I .
E-Mail t)Qyf,.tli! @, '-f"<bOO • fl(J(Y\
State or County License CACI jt ~I'll(,
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.
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