HomeMy WebLinkAboutbuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: sjisj^l 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 /
PERMIT APPLICATION FORiQa^gge Door Replacement
PROPOSED IMPROVEMENT LOCATION:
Address: Scarborough Court, Port St. Lucie, FL 34986
Property Tax ID #: 3322-507-0009-000-7
Site Plan Name:_ m(l
Project Name
Lot No.^
Block No.
DETAILED DESCRIPTION OF WORK:
Remove and replace 16' X 8' 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 .5^Windows/Doors Pond
Electric Plumbing Sprinklers Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 2,364.00 Utilities: Sewer Septic Building Height:
OWNER/LESSEE:CONTRACTOR:
Name Allan & Mary Howard Name: Kevin R. Matyjaszek
Address: ^^'^2 Scarborough Court Companv: Excelsior Construction & Roofing
Citv: State: fZ.Address: 2417 SW Washington Street
Zip Code: 34986 pax;Citv: Port St. Lucie State: PE
Phone No. 561-202-4850 ZipCode: 34953 pax;
E-Mail: allancat@gmail.com Phone No ^^2-418-8809
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:
Address:
City:
Zip:Phon
/ Not Applicable
State:
e
i-
MORTGAGE COMPANY:
Name:
Address:
City:
Zip:Phone:
Applicable
State:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip:Phone:
Not Applicable BONDING COMPANY:
Name;
Address:
City:
Zip:Phone:
Not 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 attorney before commencing work or recording your Notice of Commencement.
Signature of Cjwner/actor as Agent for Owner or/Li(^se HolderSignature of Con
STATE OF FLORIDA , ,
COUNTY OF £4-. Lucre
STATE OF FLORIDA
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
_j/_ Rhys
_tiflday of
Physical Presence or
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Online Notarization
, 202^ by
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Name of person making statement.
/Personally Known OR Produced I
Swopn to (or affirmed) and subscribed before me of
sical Prday of hCjPfuetr^
worn
1/ Physical Presence pr_
this day of fcDA
Online Notarization
202/ by
Name of person making statement.
Type of Identification
Produced
dentification.
(Signature of No
Commission No.
REVIEWS
ifniliirf fltriiiifiT
Personally Known
Type of Identification
Prodliced
OR Produced Identification.
/KittAJLUM
FRONT
COUNTER
ZONING
REVIEW
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CHARMAINECHENAULT I
if AV'i MYqOBMSSION#00947824 IEXPIl^ April 24,2021 I
(Signature of Notary Public- State of Florida
Commission No.
CHA
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION^
REVIEW
g^NECHENAULT
MY COHflgSION# GO 947824
EXPIRES: April 24,2021
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Bonded Ttiru yolaiy wiwicOi
tCAtURfLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.5/6/20