HomeMy WebLinkAboutCompleted Building Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: W-96 I Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Garage Door Replacements
PROPOSED IMPROVEMENT LOCATION:
Address. 9689 Landings Drive, Port St. Lucie, FL 34986
Property Tax ID #: 3322-500-0031-000-9
Site Plan Name: N/A
Project Name: N/A
Lot No. 9
Block No.
DETAILED DESCRIPTION OF WORK: I
Remove & replace (3) 9' X 7' & (1) 6' X 7" overhead sectional garage doors.
New Electrical Meter Second Electrical Meter
I CONSTRUCTION INFORMATION: I
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction: _
Cost of Construction: $ 6,868.00
Generator
Sq. Ft. of First Floor:
Windows/Doors
— Roof
_ Pond
Utilities: —Sewer —Septic Building Height:
Pitch
OWNER/LESSEE:
CONTRACTOR:
Name William G Rosier JR)
Name. Kevin R. Matyjaszek
Address: 3832 Southlake Drive
Company: Excelsior Construction & Roofing
City: Belton State: TX
Zip Code: 76513 Fax:
Phone No. 772-708-9370
Address:2417 SW Washington Street
City: Port St. Lucie State: FL
Zip Code: 34953 Fax:
Phone No 772-418-8809
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail info@excelsiorconstruction.net
State or County License CGC1521911
n value or consirucilon is [SVU or more, a KtcUKutu Notice of commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: I
DESIGNER/ENGINEER: V Not Applicable
Name:_
Address:
City:
Zip:
Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
Citv:
Zip. Phone:_
State
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:_
Not Applicable I BONDING COMPANY:
Name:_
Address:
City:_
Zip: _
Phone:
Not Applicable
State:
Not Applicable
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, 1 do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attornev before commencine work or recording vour Notice of Commencement.
Signature of Own e64esse on tractor as Agent for Owner
Signature of Contra o icense Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF '$/ /
COUNTY OF :!�/ Luc%e
Sw rn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
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