HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
D Permit Numb
Building Permit Applicationi
Planning and Development Services
Building and Cade Regulation Division
2300 Virginia Avenue, fort Pierce FL 34982
Phone: (772I 462.1553 Fax: (772 462-1578 Commercial Residential
IN fit MW I m1i T
PROPOSED LOCATION:
Address:
OceanLot A15,
Legal Description: 113741 FROM SW COR OF SEC 12.37.41 RUN N89 DEG 55 MIN 14 SEC E ALG S SEC L1774.41 FT TO CIL OF A1A, TN N23 DEG 49
MN31SEC kNaGSO 01292133 FT, ThN DEG 10MIN29 SECUH1 FT, TH N87DEG 33MIN 17 SEC W39312 FT THS89DEG 57 MIN 13 SEC W1334 FT, TH SIA DEG 02 MIN 43SECE 20 FT TH S89 DEG 57 MIN 13 SEC IN322.8 FT, TH. HODES 16MIN32SEC E 76021 FT,
i' ��• ) 11 'file::
Setbacks o 1,
Remove and replace" overhead ill a DA 1Tsectional do
Lot No.
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CONSTRUCTION INFORMATION:
Additional work to be ertormed underthispermit—checkall h apply:
E_
HVAC _ Gas Tank ]Gas Piping
_ Shutters ZWindows/Doors
Electric Plumbing ]Sprinklers
Generator Roof Roof
_
pitch
Total Sq. Ft of Construction:
S, Ft. of First Floor:
I
Cost of Construction: $1800.00 Utilities; _ Sewer E_ Septic Building Height:
OWNER/LESSEE;
( CONTRACTOR; 1
Name James L Peters
Name: Kevin R. Matyjaszek
Address:10751 S Ocean Dr Lot Aly
Company: Excelsior Construction & Roofing
City: Jensen Beach State: FL
Address: 1882 SE Crowberry Drive
Zip Code: 34957 Fax:
City: Port St, Lucie State: FL
Phone No. 772-229-2269
Zip Code: 34983 Fax= 772618.6660
E -Mail:
Phone No, 772-418-8809
Fill in fee simple Title Holder on next page (if different
E -Mail: info@excelsiorconstruction,net
from the Owner listed above)
State or County License: CGC1521911
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
l
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY:
Not Applicable
Name:
Name:
Address:
Address:
City, State:
City:
State:
Zip.Phone:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: ✓ Not Applicable
I
BONDING COMPANY:
2Not Applicable
Name,
Name:
Address
Address:
City:
City:
Zip: Phone:
Zip: Phone:
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 Nome Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure, Please consult with your Nome 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
bel
I i i / intend obtai, consult with n M a 1
commencing 1. 1' recording your Notice of I
Signature of Owing/Lesseeelcontractor as Agent for Owner Signature of Cont C r/Licens ` older
STATE OF FLORIDA y STATE OF FLORID
COUNTY F COUNTY OF C
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of Notary Public- State of Florida j
Personally known OR Produced Identification
Type of Identification Produced �'L) �'_,
Commission No, �rr6 1, (' (Seal]
11 Revised 07/115./2014
(Sigrratu of Notary Public- State of Florida
Personally Known OR Produced,Oentification
Type of Identification Produced
Commission No.1 (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
( COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
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