Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
HomeMy WebLinkAboutHightower_ AC Permit ApplicationA[::tpe:LicAir5N;:7:s;BicoMPLFTEDFORAppLlcATloNTOBE:::::tT::mber:
(_,_
2 -5\ -a- Nl
E EL © a I B`i art+LI Bui|dingpermitApplication
P:au:,:I,nn: :nn: :oe:ee'°R:gmue,:ttjsoenrv:jcv;ssjon comm erc-ia| i Resl d e ritilal
2300 Vjrg.Inia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERM,TAppL,cATioN FOR: #c o;i4fler c57c+
PROPOSED IMPROVEMENT LoCAT|oN: u
idir:ss..qtTti} S. CJ4pan h|'. `Lln;+ 17c/fl . rfeiou` Blath , F-L 3Ut&i_
PropertyTaxlD#.. 45T -tp02:O -0' --I I LcitNo.S.lteplanName..ul/ftB)ockNo.
projectName..in
III
DETAILED DESCRIPTION 0F WORK:\ . _ - - . ^ I . , '1 r\
L:k€ +Of Lik4 M4l L.rarzepz52AJ -:JJtisitzi/lt-i uq 3pT7On rx5an+
[thJJ3( LsiJw`(ct hacLfu jquwLi) ` Ll^ cu5', -iLJ;9 sTczf ar.
r`1
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additional 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:
Costofconstruction:S c2f7ex3~ Utilities: Sewer _Septic BuildingHeight:
OWNER/LESSEE: ,, ,CONTRACTOR: ,
Name Nn`JAr\rln HiohfroLuevF Name: KliJrr\ [A,7t` 15an
Addres:.. P0 Pro+' ti`37¢company.. e-i`e4r lbLn`b`f I`v-
city: r (J7rarndl<r state: J1 ^rdatess.. _flop) NE I)i¢;? I+fuifc;::..code. 3-a' -Fax.inZipcode:3i7ffi Fax:
phoneNo.i;*7---b4l~5:ap85
E-Mail:prhilneNIf i m2 -`( oC12 -3 fi&D ,
Fill in fee simple Title Holder on next page ( if different E.-Malil r`rer)I b Oat ®C)rr\c2; /,4o-n`
state or !ounty'iicense v,_#4 -vo.ij'3 7Z./from the Owner listed above)
lf value of construction is 2500 or more, a RECORDED Notice of Commenccmcnt is required,
lf value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
:;;-:`:?'`--.--.-'.-.,-....
`' ` ``*!RE%i
; £:m€: ffifr -Notrferwh!e
• #m¥:enGEcOMPAvrfr _ NotAppijcab,e has oMAdores:Ciity,state:
i Address:
: city, state:
i zip: phche[TEEslmpLETtTLEueLDER: __ Not App!jcabfe Zip : phone=
B0Nf2I}re ,Cen*P*Al¥:. _ifet Appl ieab!eName:Address:aty:Name : i
A£:less.' i
Zip : Phche: ,i.i.I,., „ -."-.---'rJ zip: phon e: i
OWNER/ .. en ` : A€i¥:iseason iiheefty m3i.certythatrounckorinstallatfonhascenmenedpriortotbei de to oifein a givit ta do the work and ir!Stallation as indicated`ssLianeeOfapermit.
¥u+:"t¥i€¥pc:gn:¥g¥#is¥fa%##¥deme¥irELREirEg%|t"i¥£*¥ife3#*gifehagBF#:rj##Ey%#prrbftusruech
:::=n:#:rn=£Onrif¥h:=p"rti£SigESs,r=ue#ee#a¥ji±d*9ab¥nda§:#i:ti#£lern:g£.performtheunrk
Thefollowingha]ifdingpemitarmlicato@saeexenptfromundeigr-ngafu!lconciLiqgieyrevico:rngT`a`dditioris,
arccessorystrgivrfasvichngpBds,fengesus,saps,seneenroamsaed3€certy:LJsestoawherron+esidentia1qse
fty*ft- to - "R E"iib co ftrsrm A Ifoma Or ccanencEiiE.iT only ]i=sur " yam p&yne`,..
Tap Far `.n~: T® vttR piaei¥i A .tin.cE er. enHHunmr iusr fH REconpED ArmpdsiD ed TIC -Oe simeI---..aRae " -.F.You prty Te OBmilf FbiAlicblc, corsiur
•t+i ce.€ciiiiiEicE]qu.a
OrmerSigr!aturet>ffroer/
STATE cM: FLrmDacouurSF
Name of persori making statement.
Personally Known i-OR Produced tdentrticaa±ca
Type of lderttff}ed.ari
Produced
•Sig8ature Of todectarflkense Halter
grATE OF FLORIescotrm or
#affi:yi=s ackr`o`ndedeed.before me
K_im {Ajilscin _ _
NameOfpersonJhakingstater!`ent,
Personally Krot^m ±:_ OR.Pac}duced !dentifica{ion
Type of Identification
pndueed .
i {SIgnatLlrS of *Ectary ptF5HTCL S±i€e of Fire.3({{sisFi5ha '.harry Pebrrs-give of.Fk;ridar '
crmmeslon a -I-ast#a!,EE=?`J..i::`.I-:.`.'i.-'`:.-?-`->!!.,
i c:mmi .grj.-:.--`?. r-*. .. ., -..-..-
• ... -?.*esafts*
i`.
REVIEus ?`E]. .. ! :.
=',i.<
RvisoR PLANS V
ryuq5F5K'. .GETATFOw `T _-. , .rl. - . . `±iiSEATURTLE--•,- .`MA
GRoVE|COURER -REVIEW REVIEW REVIEW REVIEW REVIEW REVI EW 1
DATERECEIVED
i IDATECC}MPLETED
ie;N.2/7