HomeMy WebLinkAboutBuidling Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: lolafijl? 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: NW Mariner Court, Palm City, FL 34990
Legal Description: MARINER VILLAGE HARBOUR RIDGE-PLAT 4- UNIT 3 (OR 1947-127)
Property Tax ID #: 4425-603-0015-000-6
Site Plan Name:
Project Name:
Lot No._
Block No.
Setbacks Front Back:Right Side:Left Side:
DETAILED DESCRIPTION OF WORK:
Remove and replace overhead sectional garage door.
CONSTRUCTION INFORMATION:
ditional work to be performed under this permit - check all ttiat ap^
I I Shutters
I I Generator
HVAC
Electric
De P6
C
Gas Tank
Plumbing
Gas Piping
Sprinklers
"7^
Windows/Doors
Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 2,080.00
Sq. Ft. of First Floor:
^ □Utilities: i I Sewer I j Septic Building Height:.
OWNER/LESSEE:CONTRACTOR:
Name Michael & Penelope Carr Name: Kc^in R. Matyjaszek
Address' 12795 NW Mariner Court
Cjty. Palm City State:.FL
Zip Code:Fax:
Company Excelsior Construction & Roofing
Address' 1882 SE Crowberry Drive
City: F'ort St. Lucie State:
Phone No._
E-Mail:
Zip Code:Fax. 772-618-6660
Phone No. 772-418-8809
Fill In fee simple Title Holder on next page (If different
from the Owner listed above)
E-Mail: ihfo@excelsiorconstruction.net
State or County License: C:GC1521911
If value of construction Is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTALCONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _/ Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:Address:
Citv: State:Citv: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: i/ Not Applicable
Name:
BONDING COMPANY: ^Not Applicable
Name:
Addr6SS* Crowberry Drive Address:
Citv:Citv:
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. Lucje 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.
Signature of Ownef^'Lesse^Ttontractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF cTA LuCf'^
The forgoing instrument was acknowledged before me
this ai day of , 20 li by
/?. IUQ4Yj'£f'S7'jJtL
Name of person making statement
Personally Known /' OR Produced Identification _
Type of Identification
Produced
otary Pu(Signature (Jf
Commission No.'Loh'iZ
ifFJ^rida fchRYSTAL GOMEZ
MY COMMISSION #FF 203322
(ije^HES: February 24,2019
Bonded Thro Budget Notary Services
Signature of Contract^^ic^se'^older
STATE OF FLORIDA
COUNTY OF 5-^ Lur:^
The forgoing instrument was acknowledged before me
this a9 day of 6r4nlcxpr- 20 by
a king staterName of person making statement
Personally Known i/^ OR Produced Identification,
Type of Identification
Produced
(Signaturemi Notary Public- S
Commission
^ wj Florida)
CHRYSTAL GOMEZ
"IMMISSiONSFF 203322
„1&: February 24,2019
Bonded Thru Budget Notary Services
REVIEWS FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17