HomeMy WebLinkAboutHurricane Shutters AC Change out permit app pg 1All APPUCABlE INFO MUSf BECOMPl.ETED FOR APPUCATION TO BE ACCEPTED
Date:· IO(l't [Z-1 PermitNumber: ____ _
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·-I? Building Permit Application
Planning and De~Sennces
Building and Code Regulatian Dittisian ./ Commercial ----Residential ____ _
2300 l/"ll!Jinia A""nue, Falt Pierce FL 34982
Phone: (m)462-1553 Fax, (772)462-1578 CBDG Funding ___ _
PERMIT APPLICATION FOR: A (!, Chin -o(,(;.{-
Address:
Site Plan Name: _____________________ _
Lot No •. ___ _
BlockNo. __
Project Name: ____________________________ _
New Electrical Meter ____ Second Electrical Meter _____ (Affidailit required)
I CONSTROCnONttlfORMAJlOR:.
Additj<>nal wort to be performed under this permit -check al that apply:
_,{ Mechanical ff!i _Gas Tank _Gas Piping _Shutters _Windows/Doors Pond
Electric _Plumbing _Sprinklers Generator Roof Pitch ----
Total Sq. Ft of Construction: ______ _ Sq. Ft. ofArst Roor. _______ _
eostoteonstruction:S 5lj:O O .60 Utilities: _ Sewer _ Septic Building Height: __ _
O~:· ·~ .. · ··.· .. ·.·. ··. '-'V .. ,,.~ t~.
Name t'l(a Name: •
Address:~0O N. Kjn,t; I::\µ)~ Company: f¼llt Nr ~
City: rfuct \)fe,ne T State: fl.. Address: cidi A Tuip(ic.JiJiu-Pd .
Zip Code: ~ I Fax: City: Fn@iuu.-State: ft--
Phone No.:t>i,wi. \kn fasst-[-.77-2,--~4-/,&----E-ZipCode: 3i.f'l~/ Fax: ____ _
Mail: #5--ZS Phone No 71J:-':://Ql,':J:/4f
fiH in fee simple TIiie Holder on next page (if different E-Mail bnv!Q. a C t '14 b 07) • Clf'rlL
from the OWner listed aboveJ State or oLnty license.~&-"--""~l a'~/8"-/~8 .... /, ___ _
If value of mnstnletion is2500 ormon,, a RECORDED Nolia! of Conmlencem• is n,quired.
If value of HAVC is $7,500 Cll' ffiCll'e, a R£COIIDED Notice of Co-01 c om Bftt Is required.
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