HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABL%, INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3////g Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: Window/door
PROPOSED IMPROVEMENT LOCATION:
Address: 6835 Bronte Circle, Port St. Lucie, FL 34952
Legal Description: OLEANDER PINES BLK 2 LOT 15 (0.24 AC) (OR 974-2790)
Property Tax ID #: 3415-705-0146-000-2 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Remove and replace (2) 8'X T overhead sectional garage doors.
CONSTRUCTION INFORMATION:
Additional work to be ertormed under this permit —check a appy:
J
HVAC Gas Tank []Gas Piping Shutters in _ Windows/Doors
❑
Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ /. Sp D, Do
ScL. Ft. of First Floor: _
Utilities:Sewer 0Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name John & Barbara Papagni
Name: Kevin R. Matyjaszek
Address: 6835 Bronte Circle
Company: Excelsior Construction & Roofing
City: Port St. Lucie State: FL
Zip Code: 34952 Fax. 772-618-6660
Phone No. 772-467-2572
Address: 1882 SE Crowberry Drive
City: Port St. Lucie State: FL
Zip Code: 34983 Fax: 772-618-6660
Phone No. 772-418-8809
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: kevin@excelsiorconstruction.net
State or County License: CGC1521911
It value of construction is 52500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: vl Not Applicable
Name:
BONDING COMPANY: /Not Applicable
Name:
Address: 1882 SE Crowberry Drive
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording your Notice of Commencement.
Rev. 8/2/17
Signature of Ovvr5errl Les 'e/Contractor as Agent for Owner
Signature of Contr r/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF 5,+ i 'c__
COUNTY OF 1&4— 1"tC -�
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this1Ll� day of 1Mcc � c" , 20 1� by
this day of YYl o, - h 20 by
t'1'eV� '-, 1'. mc'i-4 1CtS'Le Y_
�I
eVin Q_ - rnq, b 1 C'S 2- -E r, -
, -Name
Name of person making statement
Nameof person aking staterriLtnt
Personally Known OR Produced Identification
Personally Known ✓OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- St4 Wb rida tHRYSTALGOMEZ
(Signature of Notary Public- State of Florida )
MY COMMISSION # FF 203322
Commission No. F:V ���03*(Myj4ES:February24,2019
WY .0�`�CHRYSTAL GOME
Commission No. ���O33�a-2° �� al �IY 21
COMMISSION it FF
Bonded Thru Budget Notary Services
*
EXPIRES: February 24,
Bonded Thru Budget Notary S
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17