HomeMy WebLinkAboutCole AC Change out permit app pg 1All APPU':!'9r INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11 15 / :Z,1 Permit Number:
s'"•r Lu. "'Utg ~ Si. -~, ·--·_ C i c. -~--~,
~•1;;,,1~;• . ~_,/:;;';',_>-.-•,•,, --, . ~ ----~ Building Permit Application / Planning and Dew?/opment Services
Building and Cade Regulation Division Commercial Residential
2300 Virginia A11enue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR: A{ c,. Ch«nt¥ -ov:,t-
PROPOSEOIMPROVEMENT LOCATION: -
.·
Address: 4~ So,n iowto 11):(-c"Ptene,, .3495)
J
Property Tax ID #: lot No.
Site Plan Name: Block No.
Project Name:
I DETAILED O~IPTION OF WORK: I IJ lv!,. for W let: ~L o I.All u. -hvl 14--s~ ilA.lU) P4Ct ¥
lu'\ir wL 101~[11 hta:t-·
New Electrical Meter Second Electrical Meter (Affidavit required)
I CONSTRUCTION INFORMATION: I
Ad,:nal work to be performed under this permit -check aU that apply:
_Mechanical A/t _ 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: $ s, /JlJlJ. (}_ Q Utilities: -Sewer _Septic Building Height:
OWNER/LESSEE: CONTftACTOR:
Name I )t)(\ /'11/p, Name: ... ' ... --f --: ~v JI.
Address: t.l{ t ~u 'Habe:rto Company: 1 ... ,. ~1 '· ;/ IA 1 ~ l..',t 0. 'wl r •
City: YO<t-Di lfl?:: State: Address: 5J.()cf A--11 UV\ cil.t, C..Cj'.ir'P-J... -
Zip Code: tilj4'5( City: 00:: Pi"tfu I
State: Fax: -
Phone No. 111. -SQ I -'1:21 '2..-~ E-Zip Code: .~ I Fax:
Mail: Phone No -rI '),-4<, l-J.11 .+ I
RU in fee simple Title Holder on next page fit different E-Mail ~01,I.LM.t.~1.uit.0. OOl'\
from the Owner Usted above) StateorCou tylicense C.Allg[31X C, .
If value of construction is 2500 or more, a RECORDED Notice of Commencement is n!(luired.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is n!quired.