HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 6-26-2020 Permit Number:
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BuildingApplicationPermit
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Garage Door Replacement
PROPOSED IMPROVEMENT LOCATION:
Address: 4919 Pinetree Drive, Fort Pierce, FL 34982
Property Tax ID #: 3402-602-0073-000-3Lot N o. 29
Site Plan Name: N/A Block No. 2
Project Name: N/A
DETAILED DESCRIPTION OF WORK:
Remove and replace 16'X 7' overhead sectional garage door.
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
Mechanical Gas Tank Gas Piping Shutters
Electric Plumbing Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 1,400.00
Generator
---V/-Windows/Doors
Sq. Ft. of First Floor:
Roof
Utilities: Sewer Septic Building Height:
Pond
Pitch
OWN ER/LESSEE:
CONTRACTOR:
Name Linda Bollman
Name: Kevin R. Matyjaszek
Address. 4919 Pinetree Drive
Company: Excelsior Construction & Roofing
City: Fort Pierce State:
Address: 1882 SE Crowberry Drive
Zip Code. 34982 Fax:
City: Port St. Lucie State: FL
Phone No. 772-672-7790
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 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.
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: vl 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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing,. consult
with lender or an attornev before commencing work or recordiniz your Notice of Commencement.
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Signature of Owne see/C ractor as Agent for Owner Signature of Contracto ense H der
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF .Sf COUNTY OF .
Sw n to (or affirmed) and subscribed before me of Sw rn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
Physical Presence or Online Notarization Ph y
this 294A day of 07upie , 2020 by this �clay of _ Ja Ne , 2020 by
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Name of person making stateme Name of person making stateme t.
Personally Known 1Z OR Produced Identification
Type of Identification
Pro uced
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DATE
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April 241 2021
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CHARMAINE CHULT
MY COMM i0N #
947824
EXPIR S: April
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