HomeMy WebLinkAboutPotter AC Change out permit app pg 1 All APPLICABLE t iFO MUST BE C MPLEfED FOR APKICATIO N TO BE ACCEFrED
Date: Permit Number.
Building Permit Application
Planning and DeveiapmentServices
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue,Fort Pierce F[34982
Phone:(772)462-15S3 Fax:(772)462-1578 CBDG Funding
PERMIT APPLICATION FOR: chof 0wt-
PROPOSED IMPROVEMENT LOCATION:
Address:' S r. ia0 Q
Property Tax ID#: Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED RI rN OF WORK
S97FR. ii
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
' woAd 7,Mechanical
. n l rs tobe Performed under this Permit—cheek all that ap
ply.
NC ,_;_Gas Tank �Gas Piping �Shutters Windows/Doors Pond
Electric Plumbing __Sprinklers _Generator Y Roof Pitch
Total Sq_Ft of Construction: Sq.Ft.of First Floor.
Cost of Construction:$ 5.80 . 06 Utilities: —Sewer Sewer _Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name plmG Name:
Address: IDS C- Company: .A
d ss: � �' m o
Pa Y'.
City: State: - Address; hla
u
Zip Code: slFi (f)t Fax: City:941 pIC _ State:
Phone No. E- Zip Code: I Fax;
Mail: Phone No 7";l— AhA I—kt*l
Flli in fee simple Title Holder on next page(if different E-Mail
from the Owner listed above) State or Cou ty License 1 C 6 E�f 13 [#
R value aff constmwfian is 2500 or nwre,a RECORDED Notice of Cominencement Is required.
if value of HAVC is$7,500 or more,a RECORDED Notice of Conmnencemerit Is requtred.