HomeMy WebLinkAboutBuilding Permit Application 7 i
ALL APPU BLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10 t-7 Permit Number: 11 a–aaro�
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_s RECE11'rD FEB 13 207
Building Permit Application
Planning a d Development Services
Building a!I Code Regulation Division
2300 Virgrja Avenue,Fort Pierce FL 34982
Phone:(7f72)462-1553 Fax: (772)462-1578 Commercial Residential
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PERMIT 'i PPLICATION FOR: To Select from dropbox, click arrow at the end of line _D000_
Address:
Legal DesJiiiption: I:'vo,... N%P,,J Co A tf 12) Citi K I 14wc 3 510 ntn 4r st I f A, E It re-t Zo`t 7
An ► cA VVV4'b. Z.1 .A. Cr'WY 3'rPa13 a,, G,.•Ir I '76 1.11. 5 17 1, N 17(..4t, a
Property Tai ID#: 3 S 3 Z . L{ I t -Ca Oct 3 Oc�� • q Lot No.
Site Plan Name: Block No.
Project Name:
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Setbacks i Front Back: Right Side: Left Side:
Add
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itiona -orktobeoerformed under tispermit–check all ppy:
11HVA —Gas Tank ❑Gas Piping _Shutters Windows/Doors
IlElectf is ❑Plumbing 11 Sprinklers a Generator EiRoof
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Total Sq. Ft1l f Construction: SFt.of First Floor:
Cost of Coni truction:$ BE) Utilities Sewer Septic Building Height:
t.
Name �e0 hRvi E t ���^ Name: Petery Cafaro IIS
Address:.•.I� O MA-M S�. Company: Lowe's Home Centers, LLC
City: State: CL Address: P-O. Box 781993
Zip Code: q Z Fax: City: Orladno State:FL
Phorie No.1.172-- 7WL- 07_4L4 Zip Code: 32878-1993 Fax:
E-Mail: T. Phone No. _77?--941.0-3(0q
Fill in fee simple Title Holder on next page(if different E-Mail: -7-10& (-. 20-0--A-b to )moo cor^
from the O'l ner listed above) State or County License: CGC1508417
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If value of co struction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW-INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
l Zip: Phone: I Zip: Phone:
FEE SIMPLE TITLE HOLDER: of Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
i City: City: E
IZil p: 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 thepermit 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 your paying twice for
improvements to your propert . A Notice of Commencement must be recorded and posted on the jobsite
before the first inspec ' yo intend to obtain financing, consult with lender or orney before
commencing wor recordi Notice of Commencement.
Signature of kwilefSignature o Contra r/ nse Hol
i STATE OF FLORI/ ent/Les a STATE OF FLORI A
COUNTY Of COUNTY OF SLC
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The foreoing instrument was gcknowledRed beforel me The forgoing rostrum wasge acknowledore me
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thi,AOIay of C'Q 20 y i this Kay of _'2011Wy
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fPeter Cafaro III Peter Cafaro III
(Name of p a ackno ging) - (Name of person ac g1n
(Signature of Notary Public-State of Florida) (Signature of'Notary Public-State of Florida)
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
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Commission No. (Se&jftCH BOCOOK I Commission No. BOCOOK I
Notrary�Public-State of Florida `• tJotary Public •Slate of Florida
—EX4Pi94es-MaF F.26
Commission k EE 176869 '±: •�� Commiss�un d EE 176869
Revised 07/15/20 Bondea Throuoh National Notary Assn, Bonded Through K,,;.ona'Notary Assn.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
I DATE �
RECEIVED I
DATE
COMPLETED