HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED J
Date: �' 7 Permit Number:
Building Permit Application
RECEIVED
Planning and Development Services FEB 2 3 2017
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 /
Phone: (772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: Renovation
PROPOSED IMPROVEMENT LOCATION:
Address: 709 E Easy Street, Fort Pierce, FL 34982
Legal Description: INDIAN RIVER ESTATES-UNIT 06-BLK 13 LOTS 27, 28, 29, 30, 31 AND 32 (MAP 34/11S)
OR 3816-1951; 3816-2473; 3842-1877)
Property Tax ID#: 3402-607-0076-000-9 - Lot No.27-32
Site Plan Name: Block No. 13
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED,D:ESCRIPTION:OF'WORK.-,
Kitchen remodel, design and installation of new master suite including master bedroom, bathroom, and
closet. All new flooring, painting, etc. /1& ,;N ou F of exisf%tiy ex+erlar wq/t bu) Vlk� •
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CONSTRUCTION INFORMATION:
Additional work to e e orme un er t is permit—c ec a app y:
11HVAC f Gas Tank Gas Piping Shutters Q Windows/Doors
ZElectric 0 Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ 28,500.00 Utilities: Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Noam Holdings LLC Name; Kevin R.,Matyjaszek
Address:2450 NE:Miami Gardens Dr 2nd Floor Company: Excelsior Construction & Roofing
City: Miami State:FL Address: 1882 SE Crowberry Drive
Zip Code: 33180.;;. . ' Fax: City: PortSt.,Lucie State:FL
Phone No. Zip Code: 34983 Fax: 772-418-8809
E-Mail: Phone No. 772-418-8809
Fill in fee simple Title Holder on next page(if different E-Mail: kevin@excelsiorconstruction.net
from the Owner listed above) State or County License: CGC1521911 & CFC1429254
1f value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL:CONSTRUCTION LIEN,LAW INFORMATION:,
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Harvey Koehnen,Professional Engineer PE-32831 Name:
Address:7205 Elyse circle Address:
City: Port St.Lucie State: FL City: State:
Zip: 34952-3212 Phone: 772-489-3035 Zip: Phone:
i
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
P� s
Signature of 0 /Less /Contractor as Agent for Owner Signature of Contraefor/Licerf§e Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF S , ZI,,CiP COUNTY OF J-
The forgoing instrumen was acknowledged before me The forgoing instrument was acknowledged before me
this S},day of f 20 -17by this 54A day of — 20 fZ y
Kevi a Zvi ` s
=ofck wledging) ( ame of rson ckno edgi
/fSig�nally
ure of No ubli a of Florida) S�nture of Notary Public-Stateof FloridaPers Known ✓ OR Produced Identification Pely Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. FF935/lam LYNNIISWARTz L m son No. FF�3Sl7�'
==4� =1) MY COMMISSION FF 3 1� •y�, LYNN A SWAN
''fi MY cOMMISSION#FF 5173
EXPIRES:January 3 ,2020 , r-
ua 3 2020
°°j BondedThruNotaryPublicU renters
Rf f�
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE �l
INITIALS
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