HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �0.t A oPermit Number:
IMMON"Pa0h R E C E I ,D APR 2 0 2017
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED- le
P
n-71
Address: 3(to) �7
'�A -
Legal Description: i
Lale &) Nvt 6A 6 Ibkk 5 o T I EL
Property Tax ID#: (30 J (90 06 7?.-0 06 Lot No.
Site Plan Name: Ck'o' Block No.
Project Name.,
Setbacks Front_ Back: Right Side: Left Side:
0 ETAI UFA
Won -
5"lilt k'!'
M W
AOO apply:
HVAC Gas Tank ❑Gas Piping Shutters t=Windows/Doors
Electric Plumbing Sprinklers ,Generato r Roof
Total Sq,Ft of,Construction: SQ.Ft.of First Floor.
Cost of Construction:$ UtffitiesFISewer oSeptic Building Height:
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Name '//1-W/1 f'a Q00 R Name, Peter A Cafarollil
Lowes Home Centers,LLC
Address: (Aq 2>07 L-f lgam VICod Company.
City: e,&c State: Address: P-(?Box 791993
Zip Code: W Fax: City: Orlando State:FL
Phone No. Zip Code: 3287B-1993 Fax:
E-Mail: Phone No.
Fill In fee simple Title Holder on next page If different E-Mail:
from the Owner listed above) State or County License: CGC 1508417
If value of construction1s,$1500 or more,a RECORDED-Notice of Commencemerit is required.
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name: ---r
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
i
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not 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 holderto 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 Amendme s.
The following building permit applications are.exemptfrom undergoing a full concurrency revi :r om additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses o ano er non-residential use
WARNING TO O. ER:Your ur to Record a Notice of Commencement m result your pa. ing twice for
improvements Itly r prop .A otice of Commencement must be rec rded a d post o the jobsite
before the firstsl ion. f you i end to obtain financing,consul with ender o an a me before
commence wk o rec din o Notice of Commencement.
s
_Signature of ner/Lessee/Agent Signature of tractor License H der
STATE OF F DA STAT.EA.FF,IDA
COUNTY OF COUNTY e�The f ing i men was ack owledge fore me The fo oinme t was,ac cnowledg efore me
this day: L 20 by this d Ire 20 by
PETER A CAFARO Ill PETER A CAF
(Na a of person ackno dging) (Name of person acknowledge. )
tkC
I
( gnat of otary Public-State f-Fi rida) . ( gnature o, otary Public-State of FI rida
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. FF981647 StwolFlorld� Commission No. FF 9841"
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Kiiii MRIlx bw t c Sto.d of Pod"
._C0MW#"FF28J Lau
Karl M Rlo�abo fel
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Revised 07/:15/2014
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DATE
COMPLETE
INITIALS
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