HomeMy WebLinkAboutLWPPOA AC Change out permit app pg 1 All APPUCAELLE INFO MUST BE COMPLETED FOR APPUCATION TO BE ACCEPTED
Date: ` Z1 Permit Number:
Z� LL_cLL ,
k ._ Building Permit Application
Planning and Development Services
Building and Cade Regulation Division Commercial Residential
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-ISS3 Fax:(772)462-1S78
PERMIT APPLICATION FOR: _O
P OOME 3 tMPROVEME T- LOCATTW4:
Address: ltM__ `-H S
Property Tax ID#: Lot No.
Site Plan Name: Block No.
Project Name:
aE WLED DIESCRIPT I OPWORK.-
!:�i4zdl raw
l0 4-DA WA911 VaLt3EWLIL
New Electrical Meter Second Electrical Meter
.CONSTRUCnON INFORMATION:
Addi onal work to be performed under this permit-check all that apply:
—Mechanical —Gas Tank —Gas Piping —Shutters Windows/Doors _Pond
Electric T Plumbing _Sprinklers —Generator Roof Pitch
Total Sq-Ft of Construction: ScI Ft.of First Floor:
Cost of Construction.$ _00
Utilities: —Sewer —Septic Building Height:
CMNER/LMEE: CO AL70.R
Name Alf S ame:
Address:-150 3 -1l l #1iQQP iC- Company: ,jr S
City, , p State: Address: 5IdPkT '
Zip Code: MgSl Fax: City: ob& -PiLf e - -- State: R.-
Phone No. - Zip Code: 51 Fax: 3-7 3:
E-Mail: Phone No 11)L,- Ks[- A14(
Fill in fee simple Title Holder on zKwt page(if different E-MailIt. tL' ( �f DO�(rQ tY1
from the Owner risted above) State or county license CAC $)8!$(0
If value of construction is 25W or more,a RECORDED Notice of Commencement is required.
if value of HAVC is$7,5W or more,a RECORDED Mortice of Cmnnx4xement is r+equi-ed.