HomeMy WebLinkAboutCompleted Building Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Ajioju Permit Number;.
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Building Permit Application
Commercial Residential z
PERMIT APPLICATION FORiQgrage Door Replacement
PROPOSED IMPROVEMENT LOCATION:
Address: Sweetbay Circle, Palm City, FL 34990
Property Tax ID #: 4426-803-0047-000-6
Site Plan Name: ^/A
Project Name: ^/A
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK:
Remove and replace overhead sectional 18' X 7' 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 Windows/Doors
Electric Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: S 2,425.00 Utilities: Sewer Septic Building Fleight:.
Pond
Pitch
OWNER/LESSEE:CONTRACTOR:
Name Peter & Deborah Singleton Name: Kevin R. Matyjaszek
Address: '^^06 NW Sweetbay Circle Comoanv: Excelsior Construction & Roofing
Citv: Palm City State: FL Address: 2417 SW Washington Street
Zip Code: 34990 fax:Citv: Port St. Lucie State: EL
Phone No.ZioCode: 34953 pgy;
E-Mail: pete@singletonproducts.com Phone No'772-618-6660
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:
, ,j
DESIGNER/ENGINEER: _|^ Not Applicable
Name:
MORTGAGE COMPANY: ^ Not Applicable
Name:
Address:Address:
Citv: State:Citv: State:
ZId: Phone Zio: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: /Not Applicable
Name:
Address:Address:
Citv:Citv:
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 OwnerAessee/Contractor as Agent for Owner
n i.ii I I # w rr ' ' '
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF
STATE OF FLORIDA ,
COUNTY OF 5y. iMjCit.
Sworn to (or affirmed) and subscribed before me of
y Physical Presence or Online Notarizatio
this Ml day of
n
202^ by
Sworn to (or affirmed) and subscribed before me of
A Physical Presence Online Notarizatio
Name of person making statement.;mei
this ^ day of
n
202/ by
R. Ma4y^ic
Name of person making statement.
Personally Known Z OR Produced Identification Personally Known z OR Produced Identification
Type of Identificatipn
Produced
:^io Type of Identification
Produced A]/A
(Signature of Notary Public- State of Florida
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Notary Public n
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DATE
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DATE
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Rev. 5/6/20