HomeMy WebLinkAboutStaton AC Change out permit app pg 1All APPUCAB! '! MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ~~I Permit Number: _______ _
Building Permit Application / Planning and Development Se,vices
Bullding and Code Regulation Division Commercial ____ _ Residential -----
2300 V"trginia Avenue, Fort Pierce FL 34982
Phone: {7721462-1553 Fax: {n2) 462-1578
PERMIT APPLICATION FOR:
. . PROPQS·. . . . ·. ·
PropertyTaxlD#: _______________________ _ lotNo. ___ _
Site Plan Name: Block No. ---------------------------
Project Name: ______________________________ _
OJ\i'h lO K.ul h i'£tt-.
New Electrical Meter ____ Second Electrical Meter _____ _
I CONSTRUCTJON INFORMATION:
A~nal wort 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 ----
Sq. Ft. of First Floor: ________ _ Total Sq. Ft of Construction:.-.,--,-----
Cost of Construction: $ fODO , 00 Utilities: _ Sewer _ Septic Building Height: ___ _
OWNER/LESSEE:
Name.__,_-=""'--'..._.,,'1--'-_;:.:.-"-'-:,=-.i..w'l-""'--"''-"""'""""5 __
Address:.""'-'-LJ,,1-L..--'-"-'i.-'-"'-i'--L-".c.;:: ___ ..,,,,_
City: _x.1@¥J.1,m.l.J~&~~---State: ft_.
Zip Code: 3 3 0 Lr q Fax:
Phone Nofu/JA\t: furJ~ '.):(vjo7"". _() ___ _
E-Mail: j5q-t'71-1q3)?
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
· · CONTRACTOR:
Name::.J1i£ll~L1~~~----,.-----~:=:~:Jl-ft=~~u.~ ,w.
City: 6.it Piure. State: It,
ZlpCode: *· Fax:JJ2:-4°,(r3137
PhoneNo11 ►%C• .1-114-1
E-Mail boyi,-t:.te. @,'f'M'QO• /lJJ(Y\
State or County License CltCllf~l'i! (p
If value of construction is 2SOO 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.