HomeMy WebLinkAboutWebb AC Change out permit app pg 1 All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
S-n LUCIL
Building Permit Application
Planning and Development Services
Building and Code Regulation iivkion Commercial Residential
2300 Virginia avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax:(772)462-1578 CBDG Funding
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: P rt ��� LakzS aun Czah
Property Tax ID##: Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
5 I;dW
ro i cd
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Addit'nal work to be performed under this permit-check all that apply:
__Mechanical '9 G —Gas Tank Gas Piping Shutters ,Windows/Doors _Pored
Electric _Plumbing _Sprinklers —Generator —Roof Pitch
Total Sq_Ft of Construction: Sq. Ft.of First Floor.
Cost of Construction:$ A U V-m Utilities: Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name r Name:
Address:$q Q�x�dl C+ N LL r05 Company: �N�.�G�' tC. Raiv
City: Eit p� 'e State: Address: _�5 �t �tJ�ffl a- ?,f
Zip Code: 3��J�( Fax: City: it= �� (�i State:
Phone No.17; 4 -3Q.5 E- Zip Code: Fax:
Mail: Phone No
Fill in fee simple Title Holder on next page(if different E-Mail -0 dD•�dY►t-
from the owner listed above) State or County License CAIA 16 8 L
If value of construction is 2500 or more,a RECORDED Notice of Comnwncement is required.
If value of HAVC is$7,S00 or more,a RECORDED Nodoe of Commencement is required.