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Permit app
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: L ►iLLL` RNe,Pee J -_ ARM w� ``? Building Permit Application Planning and Development Services Building and Code Regulation Division Commercial Residential 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 4624553 Fax: (772) 462-1578 PERMIT APPLICATION FOR. ~ ell le _. le ve PRObeP 11UIPell RQIlEMENT LC?CAT ON, - _. ~ el" ell Address: 586 Beach AVE Port Saint Lucie, FL 34952 Property Tax ID #: 3419-510-0234-000-0 Lot No. 3 Site Plan Name: Block No. 19 Project Name: Gregory Blomberg lee "5 ell ell DETAILED DESCRIPTIOrzzOvqehell ell e ., �m_,,,� New Electrical Meter Second Electrical Meter %;, CONSTRUCT ATION ON I°I1IFORNfvle TMell 11 ell Additional work to be performed under this permit — check all that apply: _Mechanical _ Gas Tank _ Gas Piping _ Shutters Windows/Doors _ Pond Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft Construction: Sq. Ft. First Floor: of of Cost of Construction: $ , Utilities: _ Sewer _ Septic Building Height: ell =e� ovUly%/LssEE CON7`ACi"©Re,e,ell All ell lee, Name Gregory Blomberg Name: Scott Berman Address: 586 Beach AVE Company: Florida Window & Door City: Port Saint Lucie State: FU Address: 1125 N Dixie Highway Zip Code: 34952 Fax: City: Lake Worth State: FL Phone No. Zip Code: 33460 Fax: E-Mail: Phone No 561-3404300 Fill in fee simple Title Holder on next page ( if different E-Mail howard@floridawindowanddoor.com from the Owner listed above) State or County License 28576 If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required. el s IV UPPLE- a .. MCENT. g lee Vell �.,. 11 DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: Not Applicable Name: _ Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone:__