HomeMy WebLinkAboutAlfonso AC Change out permit app pg 1All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: is' ( '241 '2 I Permit Number: _______ _
Building Permit Application
Planning and Develapment Services
Building and Code Regulation Divisian Commercial Residential
2300 Virginia Avenue, Fart Pierce Fl 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address:
Property Tax ID#:
-----------
lntNo. ___ _
Site Plan Name: ________________________ _ Block No. __ _
Project Name: ________________________________ _
I DETAILED DESCRIPTION OF WORK:
New Electrical Meter ____ Second Electrical Meter _____ _
I CONSTRUCTION fNFORMATION:
Ad~nal work to be performed under this permit -check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
Roof
Pond
____ Pitch Electric _Plumbing _ Sprinklers Generator
Total Sq. Ft of Construction: -------Sq. Ft. of First Floor: _________ _
Cost of Construction: $ £+000 . ct) Utilities: _ Sewer _ Septic Building Height: ___ _
OWNER/LESSEE:
Name 0
Address: 14#1 & rs Iii'-F!oas me,,
City: ijW P(fr[(... State:fL-
Zip Code: 31¥\5 1 Fax: _______ _
Phone No. 91D-334--Dk8k
E-Mail: ______________ _
FiH in fee simple Title Holder on next page { if different
from the Owner listed above)
CONTRACTOR:
Name::....Mli.lJ~LJr:;.J~YJR.'.._ _______ _
Company:&\lle Nr Cin:li~ ~ !I~ ,:Ive.
Address: s1as ~--rwov1u. fud'zt 'M·
City: \1)((-; J>itcce,_ State: R...
Zip Code: ~I Fax: 1]:J;-Jl(,r,-3137
Phone No 11l---'-lC.r-LI {4 I
E-Mail k»yt11➔Gte @, '-fA'bOO • flncn
State or County License CAC I <J [~Ii (,
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.