HomeMy WebLinkAboutHoude AC Change out permit app pg 1All APPU:r: INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: liµt, /1--1 PennitNumber: ______ _
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Planning and Development Setvices
Building and Code Regulation Division Commercial ____ _
Building Permit Application
Residential __ / ___ _
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding ___ _
PERMIT APPLICA llON FOR: A C, Ch6.n
PROPOSED IMPROVEMENT LOCATION:
Address: 5/
PropertyTaxlD#: ______________________ _ Lot No .. ___ _
Site Plan Name: ______________________ _ Block No. ---Project Name: _____________________________ _
I DETAltED DESCRIPTION OF WORK: •
New Electrical Meter ____ Second Electrical Meter _____ (Affidavit required)
I CONSTRUCTION tNFORMATION:
Ad,:nal work to be performed under this pennit -check all that apply:
_Mechanical A/t _ Gas Tank _ Gas Piping _ Shutters
Electric _Plumbing _ Sprinklers Generator
Windows/Doors
Roof ----
Pond
Pitch
Total Sq. Ft of Construction=,-,-------
Cost of Construction:$ lf 2-({1 · 00
Sq. Ft. of First Floor: ________ _
Utilities: _ Sewer _ Septic Building Height: ----
OWNER/tESSEE: CONTRACTOR:
Name,-1,,'-l--'j!:"f,leu«c....:i:~""41<.L..-,--=---,----Name: ..fliq:!~::Ly,,..ti~~:_,r.---::---
Addres Company:.:DJU//Ltl..j~-!1,,,.n!~~h--'~,..:..-
City:LI<.L-"-'_,........,,"--_______ Stateft., Address:..!,!l~~...J.:WJU41!.11,,!i._t21!a!:?.-C~...:.._-
Zip Code:3!:l'i51 Fax:_______ Cilv:AA:: 'Ptyu State:
PhoneNo.l.t?.>Z•'l.3i-3o'll E-ZipCode: .3t/tt51 Fax: _____ _
Mail: PhoneNo11,--4C.l-4-f4-I
Fill in fee simple Title Holder on next page (if different E-Mail r,o ~a,c. t.\f 1&1110 • C6rt'
fromtheOWnerlistedabove) StateorCoudtvLicense C.Allgflt\X f,
H value of construction is 2500 or more, a RECORDED Notice of Cammencement Is required.
H value of HAVC Is $7,500 or more, a RECORDED Notice of Commem:ement Is required.