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All APPLICABLE IN MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: 3no Permit Number:
RECEIVED
91r.
Q) NOv"2 3 2020
Building Permit Application permitting Department
Planning and Development Services st. Lucie County
Building and Code Regulation Division Commercial Residential L//
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Remodel
PROPOSED IMPROVEMENT LOCATION:
Address: 13 Majestic Way, Fort Pierce, FL 34949
Property Tax [D#: 1414-701-0172-000-2 Lot No. D
Site Plan Name: Block No. 18
Project Name:
DETAILED DESCRIPTION OF WORK:
Kitchen remodel, remodeling both bathrooms, relocating laundry room. Creating larger master suite within existing footprint.
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
Mechanical Gas'Tank - Gas ll�lpfhg Shutters ✓/W in d'o' �i s's/'D oo r's Pond
E lectric 01 uhibind- `Spei n-nklers —Generator R60i. pikfi
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:,$ Utilities: —Sewer _L/Septic Building Height:
OWNER/LESSEE: 2
CONTRACTOR:,
rn Kevin 11'` K4 &yJ 0'
Address
-6c'on u Qri,&,Roofing
Comp,
Tallafiasseb %
k State: FL
Acld'ress;1.882�SE -70row r�,&ive
Zip C-ode: Fax: :
City: " 0 State: FL
Phone No. 561-315-9360
Zip Code: 34983 Fax: 772-618-6660
E-Mail: mikeposlaiko@gmaii.com
Phone No 772-418-8809
Fill in fee simple Title Holder on next page (if different
E-Mail info@excelsiorconstruction.net
State or County License CGC1 521911
from the Owner listed above)
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.
I -SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: ✓ Not Applicable
Name: A rs Name: �,ye Ad,
Address: Address: / e .5220
City: Vero Eap State: -F—/-- City: a -T State: T'
Zip: 39G,7 Phone 7-M- o' Z/ Ja -gook Zip: ;V,�7g_ Phone:
FEE SIMPLE TITLE HOLDER: t/ Not Applicable
Name:
Address: `
City:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
of 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 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.
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Signature of Ownesse ontractor as Agent for Owner
Signature of Contracto ense Molder
STATE OF FLORIDA
Zael
STATE OF FLORIDA
COUNTY OF 1_6ce,'P
COUNTY OF 4�1, e
Swgfn to (or affirmed) and subscribed before me of
Swopto (or affirmed) and subscribed before me of
Physical Presence or--�-Online Notarization
by
Physical Presence or Online Notarization
2020 by
this Aday of ll�ou¢I,,c�D�� 12020
thisday of I/e/� ,
,eev / P, /�a�ri)aSzP�
%v R.
Name of person making statemdrK
Name of person making statement.
/
Personally Known d OR Pro uced Identification
Personally Known 0 rod ced I entification
Type of Identification
Type Identification
Produc
Pr du Pre
(Si u of Notary P o Sri a
atery utNic State of Florida
(Sig tf Notary Pu t FICA public state of Florida
Michael A Poslaiko
Commission No. WGQM$is3ionGG957928
M ael A Poslaiko
GG957928
ommission No. I�� /�
Ex ' 12/2024
orw Expires 02/12/2024
or
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/b/20