HomeMy WebLinkAboutMasingale AC Change out permit app pg 1All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 8r.3t[ 2-1 Permit Number: _______ _
Building Permit Application ✓ Planning and Development Setvices
Building and Code Regulation Division Commercial ____ _ Residential _____ _
1300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
r:
PropertyTaxlD#; l~ol ~CeDl -Do sg "000-0 Lot No. ___ _
Site Plan Name: ________________________ _ Block No. __ _
Project Name: ________________________________ _
DETAILED DESCRIPTION OF WORK:
New Electrical Meter ____ Second Electrical Meter _____ _
I CONSTRUCTION INFORMATION:
A~nal work to be performed under this permit-check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
Roof
Pond
Electric _Plumbing _ Sprinklers Generator ____ Pitch
Total Sq. Ft of Construction: ______ _ Sq. Ft. of First Floor: _________ _
Cost of Construction: $ 4000. ()() Utilities: _ Sewer _ Septic Building Height: ___ _
OWNER/LESSEE:
Name-+=-=--'--7'~:"""''-'-'-'<-<l",,....""---,_--=-----
Address::FL-/70ri'.ll,-~"'--'-'=--'-"""'-"'"""""--=:-----=--
City: n)( I State: fv
Zip Code: 5l¥!5" I Fax: _______ _
Phone No. 17J, ◄ fE_l-1. ~ 3"1l/: 3
E-Mail: ______________ _
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name:_nlC.l](AlJLJJ~ll/!,..__ _______ _
~~;:::~=~~~-t~tfg/~ttns ,Mlf-
City, n.i<t Pitrce.. State: R...
Zip Code: 3&-)':tSI Fax: 1]:J.-JJ{,(,-&137
Phone No 11,.,._L:K, [ • l-114-I
E-Mail 'ooyflLGW. !, '-{'WOO• /ln(Y\
State or County License CACIZ1'81'8 (p
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.