HomeMy WebLinkAboutDavies AC Change out permit app pg 1 - CopyAll APPLICAB INFO UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number.
Building Permit Application
Planning and DeMopment Services
Building and Code Regulation Division Commercial Residential
2300 ilirg&sa Avenge, Fort Pierre FL 344982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: All: C _Otbe,
PROPOSED t PROVEM€NT LOCATE:
Address:
Property Tax ID li:
Site Plan Name:
Project Name: _
New Electrical Meter Second Electrical Meter
CQNMVCT 0N:1NPORMA`i ON:
Lot No.
Block No.
Addi anal 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: ,r� Sq. Ft. of First Floor:
Cost of Construction: $ 3-160• Q 0 Utilities. — Sewer _Septic Building Height:
O NER/ SSEE: -
CO TRi ►CT 3R:
Name Its
Name
Address:
.r,,�
City: (I.2fCQ. 0 State
Company: f S
Address: CJ AT
Zip Code.• 8 ;-- Fax:
Phone No. • Z —42 85
City; t State: X•
Zip Code: l Fax:,11s-1 Vdc 37 3:7
E-Mail:
Phone No - 14141
Fill in fee simple Title Holder on next page ( if different
E-Mail LbL 06.
from the Owner listed above)
State or County License
rr vB'ue oT cmmrucnan i5 Z.'AW or moire, a Ht[.UilWLU rMti a of comrnencerrmit is required.
If value of HAVC is $7,500 or more, a RECORDED Not of Conunauxmumt is required.