HomeMy WebLinkAboutCompleted Building Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 09 Id 0010 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: Door Replacement
PROPOSED IMPROVEMENT LOCATION:
Address: -tt ` S Ocean Drive ;;670, Jensen beach, r-L
Property Tax ID #: 4511-805-0071-000-0 Lot No. 71
Site Plan Name: N/A Block No.
Project Name: N/A
DETAILED DESCRIPTION OF WORK:
Remove and replace 14' 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: $ 1,980.00
Generator
Sq. Ft. of First Floor:
V Windows/Doors _Pond
Roof Pitch
Utilities: Sewer Septic Building Height:
OWN ER/LESSEE:
CONTRACTOR:
Name Richard Englesbe & Maryann Englesbe
Name: Kevin R. Matyjaszek
Address: 595 Seton Circle
Company: Excelsior Construction & Roofing
City: Lakewood State: NJ
Address: 1882 SE Crowberry Drive
Zip Code: 08701 Fax:
City: Port St. Lucie State: FL
Phone No. 908-216-6610
Zip Code: 34983 Fax: 772-618-6660
E-Mail: englesbe@aol.com
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
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 attorney before commencing work or recording your Notice of Commencement.
Signature of Contract tense older
Signature of Owner/ L4see/Cohfractor as Agent for Owner
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF .5�, Lu��e
COUNTY OF
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