HomeMy WebLinkAboutZebrowski-Permit Application Corrected 042620216
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 4tF2612020 • REVISED
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Perms NUM"nber.'
Building Permit Application
Plonning and Development Services
Building Qod Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL. 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial
Residential x
PERMIT APPLICATION FOR: poY*-roopoolf/l enclosure/front entry on existing slab
.. ..... ...............
.... .......
.PROPOSED IMPROVEMENT LOCATION,
Address: 7510 Lakeland E31vd, Ft Pierce, FL 34951
Property Tax ID 1301 �607-0003,000-1
Lot No,.,
Site Plan Name-, Block No,
Project Name: Zebrowski-polyllpool enclosure existing slab; Front entry an existing slab _
DETAILJED DESCRI ION OF WORK.
Furnish and install poly roof/pool enclosure over existing pooh on existing concrete siaa.
. .... . ....Furn....
ish and install front entry on existing slab.
............
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New Electrical Meter N/A S
CONSTRU ION INFORMATION:
Additional work to be performed
M echa nica I
E1ectr're
Gas Tank
MENWINM~
Plumbing
under this permit —check a!1 that apply:
TotalSq. Ft of Construction,.
-------------
Cost of Construction.: $ 21,OQO
OWNER/LESSEE,
Name Kathy & Joseph Zebrowski"
Gas Piping
� Shutter's
Windows/Doors
� Pond
Sprinklers
I Generator
Roof
Pitch
Address:7510 Lakeland Blvd
C�ty. Ft Pierce FL State:
Zip Code;34951 � Fax,,, NONEW..
.......... ------
Sq. Et. of first Floor:
Utilities: � Sewer _Septic Building Height-,
Phony No. NONE
EOM41 j-1 v. NONE
Fit! in fee sample Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
3 Name.
DanDozack
EMI. IPIIl�����A�11 IUIII IIIII III 91V7111VI11 ii �un�rnu�x.u�iA�r��n�n..r..r....��.�.r�r�.r��.�r..�
Company: Dozack Construction, LLC Address: 1741 SW Anderson St
City* PSL State.- FL
Zip Code: 34953 Fax,.,
Phone No 772-801-4083
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E-Mail RHScreenLLC@gmail.com
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If value
of
construction is
2500 or more, a RECORDED Notice of Commencement is required,
If value
of
HAVC is $7,SOO
or more, a RECORDED Notice of Commencementi's requireri.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATIONO
DESIGNER/ENGINEER:
„^ Not Applicable
Name,
Address;.
City"'. State:
Zi P• Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name: f
Address.
City
Zi P Phone:
�4rImiFL1���L7���nL7����nm�n'4M}MF - -
MORTGAGE COMPANY:
Name:'At' t&i
Address,:
Ctty: �� a
zip: Phone:
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BONDING COMPANY: Nct -N
Akablepc,.11
N 0-% m e.', N!!
Address.:
city: ... ...... .
Phone-
OWNER/
CONTRACTOR AFFIDVIT: Applicationsmade obtainpermitt tx lv � . .
I certify that no work or installation has commenced priorthe issuance of a permit,
St. Luce Count makes representation that is .11 authorize thepermit4W e it bu-;"d r strut+ r
which is ' ct with liable Home Owners Association rules laws v" E hat la t� � - prCMinA sut�
•r structure, Please consult with your Home Owners Association and review your deed fcr any, Cw'tie iv -
Ire consideration of the granting of this requested permit,I do here - r that I willf, tn a," respectsi., perform t" �Vcrk
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Annend'ments.,
The followingbuildingpermit applicationsare exec from undergoing full c ��re review-, � ar, c ' -om
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses ',"o anotzrner nan-itresisd..entta, Use.
WARNING TO OWNER*, Your fa'Iture to Record a Notice of Commencement may result in paying twice for
improvements to your property. A Notice of Commencement must be recorded in. 1[he ioublic records c� 'S�.
Lucie County and pasted can the jobsite before the first inspection, If you intend tc abtaF1'1 finar4cing., consu'L
rm"with lender or an attorney before corr�mencin v�ark or recar€�{n�your Notice of Comeme_ent.
Signatu�eloj Owner/ LesseeXontraftor as Agent for Owner
STATE OF FLORIDA
COUNTY OF sT 1.ucie
Sworn to (or affirmed) and subscribed before me of
x Physical Presence or Online Notarization
this 26th day of April 2020 by
Dan Dozack
Name of person making statement.
E ".".4ft Wft ,ter ##■ s — Aw.%-.a& V
Sign atur�e�c�ntractorj ; License Holaer
STATE OF FLORIDA
COUNTY OF s E
Sworn t r affirmed' and subscribed be
Physical Presence or OnlineNotart.,zation
h 2 day Y, � .by
man a`ti3-lch' *,
Name of person making statement'.
Personally Known x OR
Type of Identification
Praduced
5 �M}%• rt 1I ��
(Signature of �%tt- F I, S
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4 x
Commission 4
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SEA TURTLE
REVIEW
MANGROVE
REVIEW'