HomeMy WebLinkAboutRevised Building Permit Application - new application 2011-0578 revised 11/24/20All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number: SOll'QSyS'Date:
^ 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 Resid ential /
PERMIT APPLICATION FOR: Remodel
PROPOSED IMPROVEMENT LOCATION:pit
Address: Majestic Way, Fort Pierce, FL 34949
Property Tax ID #: 1414-701-0172-000-2
Site Plan Name:
Project Name:
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK:
Kitchen remodel, remodeling both bathrooms, relocating laundry room. Creating larger master suite within existing footprint. Relocation of water
heater to be replaced with new tankiess heater and relocation of existing HVAC air handler to garage.
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit - check all that apply:
7,
dlti(
A
A Electric
Mechanical .GasTank Gas Piping Shutters
Plumbing
t/^W
Total Sq. Ft of Construction:
Cost of Construction: $ 55,000.00
indows/Doors Pond
Sprinklers Generator Roof Pitch
Sq. Ft. of First Floor:
Utilities: Sewer j/'septic Building Height:
OWNER/LESSEE:CONTRACTOR:
Name Michael & Sara Poslaiko Name: Kevin R. Matyjaszek
Address: 4917 Vernon Road Comoanv: Excelsior Construction & Roofing
Citv: Tallahassee State: FL Address: 1882 BE Crowberry Drive
ZioCode: 32317 pgx:Citv: Port St. Lucie state: FE
Phone No. 561-315-9360 Zip Code: 34983 p3x; 772-618-6660
E-Mail: mikeposlaiko@gmail.com Phone No 772-418-8809
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail info@excelsiorconstruction.net
State or Countv 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:
Name:
Not Applicable
Address: f/SGS
City: Vtte BeacA
Zip: 33907 Phone
state: /:z
/ ^ot Applicable
MORTGAGE COMPANY:
Name: Houepcho-^ F/vctA^cr'o
Not Applicable
Name: Houepohot t/v^tjucra i
Address: //S"// lu^a knaJ^
City: fjiruei^ ^nm/cA ^
Zip: rs'i??/ Phone:
State: TV
/NiNoFEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip:Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip:Phone
t Applicable
:
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 ail 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 Owner/i^see/Contractor assent for Owner
STATE OF FLORIDA)RI
COUNTY OF \ or.^
SwopHt5 (or affirmed) and subscribed before me of
^ Physical Presence or Online Notarization
Signature of Contrae^f7Licens^°Hoider
STATE OF FLOmDA
COUNTY OF
this^ Oday of IO(;>^fwWcr , 2020 by
i o Ma-V vpasZ-tX-
Name of person making statement.
OR Produced IdentificationPersonally Known
Sworp-to (or affirmed) and subscribed before me of
^.^Physicai Presence or Online Notarization
this rk'O day of )Oc)\)CLyY\ VtC 2020 by
k (>\)] o A a^icX-
Name of person making statement.
Type of identification
Produced \- L - L) '—•
Personally Known OR Produced identification
Type of Identification
Produced Pl^ n Qv—
(Signature of (totar
Commission
MliNELLt GHttN
Notary Public - State of Florit
Commission # GG 286318
(SysDmrn. Expires Dec 20, 20
ed through National Notary As
inatureI
mCHELlE GREENotyfy Public- Statef^fTrprffla ) . state of f
noi ■7 \<? Commission # GG 286:2C immission NobLo0U>6)f) g. V '.'fSeaJ^amm. Expires Dec 20- tjiiiidSS through National Notary / : in.
REVIEWS FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETEDftev. 5/6/20