HomeMy WebLinkAboutMeenan AC Change out permit app pg 1All ~INFO MUST BE OOMPl£TED FOR APPLICATION TO BE ACaPTED
Date: J.!B(Z-1::: Permit Number. ______ _
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Planning and Development Services
Building and Code Regulatian DMsioo Commercial ----
Building Permit Application
Residential_/ ___ _
2300 Virginia AllellUe, Fart Piera, Fl. 34982
Phone: (7721462-1553 Fax: (772) 462-1578 CBDG Funding ___ _
PERMIT APPLICATION FOR: A (!,, CM.n
PROPOSED IMPROVEMENTtQCATION:
Lot No. __ _
Site Plan Name: _____________________ _ BlockNo. __
Project Name: ____________________________ _
I DETAltED DESCRIPTION OF W()Jtt(.:
New Electrical Meter ____ Second Electrical Meter _____ (Affidavit requiredl
I CONSlltUCTION INFORMATION:
Additjonal wort to be performed under this permit -chedc an that apply:
_ii Mechanical A/C. _ Gas Tank _ Gas Piping _ Shutters _Windows/Doors Pond
Electric _Plumbing _ Sprinklers Generator Roof ____ Pitch
Total Sq. Ft of Construction: _____ _ Sq. Ft. of First Floor. _______ _
CostofConstruction:$ 5 ()OQ. bO
I
Utilities: _ Sewer _ Septic Building Height: __ _
OWNER/tESSEE: CONl'RACTOR:
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Name:J...t,LJ!.J.U..!j~.L:..WCJ¾'Ct.<-1-JI.WLL-~=-,..L!~.:__ Name:
Add • __J""'--AWJ.-__:::J'-r-.:...!!=-------,--
City: OY\/1 D 1-fLl State:~ Address:~~P---U"'1.U..~..__,c:.t111=_=..,e=...:..._
Zip Code: 3 3 DC, q Fax:_______ City: 00:: P,uu State:
PhoneNo:11J,-33l-~qZ.! E-ZipCode: 3/¥151 Fax:
Mail: PhoneNo-n,--4<.1-414-1 ------
FiUinfeesimpleTitle Holder on natpage (ifdiffete.tt E-Mail loo\/W½f&iu@. C6)'r\
from the OWner 6sted above) State or eoudtv License C.Al!g(ll\3 £1
If value of construction Is 2500 or naore, a RECORDED Notice of C-~ ls ,equired.
If value of HAVC Is $7,500 or"'°"'• a RECOROEO Notice of Co.cw o t!fflellt is required.