HomeMy WebLinkAboutViscido AC Change out permit app pg 1All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 913j 2/ Permit Number. _______ _
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i: Building Permit Application
Planning and Development Services
Building and CDde Regulation Division Commercial ____ _ Residential / -~---
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 'rir,.._ (11t<, [ 1
PropertyTaxlD#: (?()I -C., It -DO l('i. LotNo. ___ _
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 Pond
Electric _Plumbing _ Sprinklers Generator Roof Pitch ----
Total Sq. Ft of Construction: ______ _ Sq. ft. of First Floor: ________ _
Cost of Construction: $ J.\ q oO . 6D Utilities: Sewer _ Septic Building Height: ___ _
OWNER/LESSEE: ---CONTRACTOR:
Name l/'l<.onlt\ \ I, ",{'.ui n Name: .. _, f' .... ., ..
Address: ""1 ~OS ?'ilN\-!zt. C[a..rtl. BtLtt.., ~~;::;~~~.tn~~~=tt~ ~ City: nJ (I-; 1Ntf ce.,, State:J::l..,.
Zip Code: 344'51 Fax: City: i:n<t ~it.«" State: It.
Phone No. Mi. -~13-X!:f:'.l---O'tDJ-.... Zip Code: ~, Fax: JJ2_-fUt:: 3 7 '5-:J_
E-Mail: Phone No 111,,-LK. I• £114-I
Fill in fee simple Title Holder on next page ( if different E-Mail bt,yt1.an. @, '-{Af.~• ~ll'.l
from the Owner listed above) State or County License Cl!C 11 l ii :8 C,
H value of constniction is 2500 or more, a RECORDED Notice of Commencement is required.
H value of HAVC is $7,500 or more. a RECORDED Notice of Commencement Is required.