HomeMy WebLinkAboutFolk AC Change out permit app pg 1 - CopyAll APPLICABf,E INF MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 ·'VD :2-( Permit Number: _______ _
Building Permit Application
Planning and Development Services
Building and Code Regulatian Division Commercial ____ _ Residential __ ✓ __ _
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (n2) 462-1553 Fax: (n2) 462-1578
PERMIT APPLICATION FOR:
Address:_ULJ~=---l-l-!l-..l-<......!J""l.<'-'-'-lLLl.L.J_J:.),,.~......--L..1.o'-!...!.L..::LJS;...!..!..""":__ __________ _
PropertyTaxlD#: _______________________ _ lot No .. ___ _
Site Plan Name: _______________________ _ Block No. __ _
Project Name: ______________________________ _
I DETAILED DESCRIPTION OF WORK:
IJ i-tn to 1Cw Vlltc:t .
New Electrical Meter ____ Second Electrical Meter _____ _
I CONSTRUCTION INFORMATION:
Ao/.~nal 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: ________ _
Cost of Construction:$ ~'2..0 0 • 00 Utilities: _ Sewer _ Septic Building Height: ___ _
OWNER/LESSEE:
Name,--J..d.l4--.'.1..-!,!.1,C>o.!.-~---~----
~~~eflifnW£t L
State:ft,
ZipCode: ;3yq5! Fax:. ______ _
PhoneNo.tS'S~ g1q-:Z:315
E-Mail:. ______________ _
Fill in fee simple Tll:le Holder on next page ( if different
fromtheOwner&sted above)
CONTR:Aq-OR:
Name::~i£tltUJ~~~fl._--~-~--
==:~=~~.{t=itTg,~t.~ ;Lr..
City: 6if Piurl. State: It.-
Zip Code: 3i:fl.SI Fax: JJ;i-JJ(,r,-37 37
PhoneNo11l.,-Li(,I• £114-1
E-Mail boyit.lll!. @, '-fM'O{). /ll)f'(I
State or County license CM I jl ii Z C,
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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