HomeMy WebLinkAboutGould AC Change out permit app pg 1 Alf APPLICABLE INFO MUST BE CDR04 EM FOR APPLICATION TO BE ACCEPTED
Date: 2Z Permit Number:
LUCtL
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. � Building Permit Application
Planning and DeviekWment 5erviaas /
9uikling and Code BeguJf to D meson Commercial Residential
23W Vagina Avemw,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 CBDG Funding
PERMIT APPLICATION FOR: At c. Cho owl
Address: r r - d s
Property Taut 10#: Lot No.
Site Plan Name: Block No.
Project Name:
'0ETAffJE6-0E$WPTMW '
uu ' , .2,sbn
New Electrical Meter Second Electrical Meter (Affidavit required)
Addit' I work to be p� check under this permit-che all that apPh-
_,.Mecltaniicai NC, Gas Tank ^Gas Piping, _Shutters �Windows/Doors __Pond
Electric —Plumbing Sprinklers __Generator Roof Pitch
Total Sq.Ft of Construction: Sq.Ft.of First floor.
Cost of Construction:$ J .00 Utilities: Sewer _Septic Building Height:
Name D • Name:
Address: qni �I 4J Sr, [�1 Company; "A
city: State:A- Address. R if
Zip 30[R Fax: car. State:
Phone No. 4wd&S UUIVZ E- Zip Code: 1 Fax:
Mail: :57 1 -_6 23 b Phone?
{ Fill in flee simple Tide Helder on next page(if different E-Mail D . m1,
from the Owner listed above) State or Coul6license CACIAL Zia to
If value of cmubucdw Is 2SW or more,a RECORDED 11 1 Urp of k requiieci.
N value of HAVC is$7,=or inane,a RECORDED Natke of Cowamwocenteft k required.
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