HomeMy WebLinkAboutLalonde AC permit change out app pg 1All APPLICABLE INl'O MUST BE COMPLETED FOR APPLICATION TO BE HXEPIEO
Date: I( l3 0 I i,/ Permit Number: ______ _
8}~=~!) 1;trv~4;;1t;wr~.)ir,,~~~:~~ Building Permit Application
Residential
Planning and Dew,/opment Services
Building and Code Regulatian DMsian Commercial ___ _ -----
2300 Virginia Avenue, Fort Pierce Fl 34982
Phone: (7n) 462-1553 Fax: (772) 462-1578 CBDG Funding ___ _
PERMIT APPLICATION FOR: A C,. CM.rt -0!.hr
Address:
Site Plan Name: _____________________ _ BlockNo. __
Project Name: ____________________________ _
I DETAILED -DESCRIPTION OF WORK: ---, -
New Electrical Meter ___ Second Electrical Meter _____ (Affidavit required)
I CONSTRUCllON tNFORMAlJON:
Adcflljonal work to be performed under this permit -check aB that apply:
~Mechanical A/C _GasTank _Gas Piping _Shutters Windows/Doors Pond
_Plumbing _Sprinklers Generator Roof ____ Pitch
Total Sq. Ftof Construction: ______ _ Sq. Ft. of First Floor: ________ _
Cost of Construction: $ q% 00 • DO Utilities: _ Sewer _ Septic Building Height: __ _
OWNER/1.ESSEE: rA...,....Ar'Tnft. '-'-"'' """'""·-'"'·
Name:
Company:-?1UHJLJ~l.L.!P,-,-J[lll.~~~~::..• _
Address: -=>><=.+->-~.,.....-4""""'....c~.::...__;..;:::___' _
Zip C _-"---c!~--= Fax:_______ Citv: l'Ott:::: Pi't«e State:
PhoneN A(gll'J~ ?5?3 E-ZipCode: Jqtf;J Fax: _____ _
Mail: Phone No 71,--4<, 1-"14-1
Fill in fee simple Title Holder on next page (if different E-Mail ~l,\.e ~j4i!@. C4}'Y\
from the Owner listed abowe) State or Coudtv License C.Af. I g{ll.l X <,
If value of COIIStrUction Is 2SOO or more, a RECORDED Notice of Comme,icement Is required.
If value of HAVC Is $7,500 or more, a RECORD£!) Notk:e of Commencemfflt Is ll!qUired.
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