HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 6'Permit Number:
8l9
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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 TYPE: Garage Door Replacement
PROPOSED IMPROVEMENT LOCATION:
Address: 5415 Davis Street, Fort Pierce, FL 34982
Property Tax ID #: 3409-501-0048-000-0
Site Plan Name: N/A
Project Name: N/A
DETAILED DESCRIPTION OF WORK:
Remove and replace overhead sectional 16' X 7' garage door.
CONSTRUCTION INFORMATION:
Lot No. 48
Block No.
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters Windows/Doors
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 1,680.00
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name Shirley Colon
Name: Kevin R. Matyjaszek
Address: 5415 Davis Street
Company: Excelsior Construction & Roofing
City: Fort Pierce State: FL
Zip Code: 34982 Fax:
Phone No. 772-475-6278
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: shirlcolon@gmail.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail info@excelsiorconstruction.net
State or County License CGC 1521911
It value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
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.
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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Own essee ontractor as Agent for Owner
Signature of Contraef`otfLicensOd older
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF _'5{. Lut%c
COUNTY OF _51, 41Ue-,e
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Rev. 2/7/19