HomeMy WebLinkAboutBuidling Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
--------- -- - -- - ----------- . . ... ...... -- - --------- ---- -- - - - - - --------------- - 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: 7219 Reserve Creek Drive, Port St. Lucie, FL 34986
Property Tax lD#: 3322-601-0003-000-4
Site Plan Name: N/A
Project Name: N/A
DETAILED DESCRIPTION OF WORK:
Remove and replace overhead sectional 18'X 7'garage door.
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
Lot No.
Block No.
Mechanical _Gas Tank Gas Piping Shutters Zwindows/Doors
Electric Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction:
Cost of Construction: $ 2,315.00
Sq. Ft. of First Floor:
Utilities: Sewer Septic Building Height:
Pitch
OWNER/LESSEE:
CONTRACTOR:
Name Frank M Dework Lesley C Dework
Name. - Kevin R. Matyjaszek
Address: 7219 Reserve Creek Drive
Company: Excelsior Construction & Roofing
City: Port St. Lucie State'.
Address: 1882 SE Crowberry Drive
-
Zip Code. 34986 Fax:
Port St. Lucie
City: State* FL
Phone NO.
Zip Code: 34983 Fax. 772-618-6660
E-Mail:
Phone No 772-418-8809
Fill in fee simple Title Holder on next page if different
E-Mail Info@excelsiorconstruction.net
from the Owner listed above)
State or County License CGC1521911
IT value or construction is:>/-!)Uu 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
Not Applicable
MORTGAGE COMPANY: pp
�
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.
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 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."
146�000
Signature of Owner/ see/ ntractor as Agent for Owner
Signature of Contracto nse H er
STATE OF FLORIDA ,
� �Vere
STATE OF FLORIDA A
COUNTY OF zv4rl C
COUNTY OF
The for oing instru e was acknowledged before me
as acknowledged before me
The forgoing instrumWet
this j day of G , 200? by
this day of �I'I' , 20 by
e Al A)445 ze
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Name of person making sta ement.
Name of person making stateme t.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signatu e f Notar%ubli -State of Florida)
(Sign e o N tary Public -St' o I rice )
,�tAAy pue CHRYSTAL GOMEZ
Commission No. a * Seal)Commission# GG 2895
�e CHRYSTAL GOMEZ
OCommission No. l * JSea,6misslon # GG 28955
Expires February 24, 20
3 IPA' Expires February 24, 202
Bonded Thru Sud et
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REVIEWS
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ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19