HomeMy WebLinkAboutBuidling PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7/o Permit Number:
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: 5403 E Echo Pines Circle, Fort Pierce, FL 34951
Property Tax I D #: 1312-500-0130-000-6 _ Lot No. 129
Site Plan Name: N/A Block No.
Project Name: N/A -
DETAILED DESCRIPTION OF WORK:
Remove and replace (2) overhead sectional garage doors. 16'X 8'& 10'X 8' doors.
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 /Windows/Doors Pond
Electric Plumbing Sprinklers Generator Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 2,485.00
Sq. Ft. of First Floor: _
Utilities: Sewer Sept is Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Karen M Wiedemeier
Name: Kevin R. Ma-tyjaszek
Address: 5403 E E,gho Pines Circle
Company: Excelsior Construction & Roofing
Cit Fort Pierce State: FL
City: A.
Address: 1882 SE Crowberry Drive
_
34951 -�
Zip Code. Fax.
Port St. Lucie FL
City. State.
Phone No.
Zip Code: 3498.3 Fax: 772-618-6660
E -Mail:
Phone No 772-418-.88)9
Fill in fee simple Title Holder on next page ( if different
E -Mail info@excel;�ior,-.onstruction.net
from the Owner listed above)
State or County License CGC1521911
If 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: 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 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 recording vour Notice of Commencement.
Signature of Own er7�see/Cont> or as Agent for Owner
Signature of Contractor/.6e6nse Holder "
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Zuet
COUNTY OF Zaelle
Swo nto (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
Physical Presence or Online Notarization
this day of J"IV 2020 by
this ggAday of J , 2020 by
KeM'd #Q 1V f 'e P - -4
a 7� J&? 5zrz
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
LX
Produced
04")y -
(Signature of Notary Public- State of Florida)
(Signature of
....,," CHARMAINE CHENAULT
'f40AW1
Commission No..�P,:;•-,(SeaIb�NECHENAU
TCom fission N M M SIGN#ft*824
MY COMM SfON # GG
o.
1824 ' . EXPIRE : Ap!124, 2021
,.'� • .. oaf.
�F
Q 0% A•.
. ,.cypipr.5to Anr
F� .•
Thrugm
REVIEWS FRap
S VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW
REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.