HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ZI l� Permit Number: IVY" �C55 3.
DECEIVED
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- - --- - wilding Permit Application APR 2 6 2011
Planning and Development Services
Building and d Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(7172)462-15 53 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Address: 22. A ( (Aw 1✓?
Legal Desc eliption: t-10J36, ,�6vy_ f'-skkk —, 41)
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Property Tax ID#: L(,69 5-0 3 . 00 2-0 —oCxo- Lf Lot No.
Site Plan Name: 6,4,A 5cyt, r- Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
19
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Additional rrk to be ed un er t is permitcneck a appy:
C�HVACGas7ank ❑Gas Piping _Shutters ,Windows/Doors
Electric El Plumbing Sprinklers n Generator a Roof
Total Sq. Ftiof Construction: Sq. Ft.of First Floor:
Cost of Construction: Z
$i 20���� 'Utilities: _Sawer®Septic Building Height:
Name Name: Peter C:afaro III
Address:.•..�-Z�i '4ao C'� Company: Lowe's Home Centers, LLC
City:' "r p ���!� . _ Stater-- Address: P.O. Box 781993
Zip Code: 'Fax: City; Orladno State:FL
Phorie No, Zip Code: 32878-1993 Fax:
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E-Mail: i Phone No.
Fill in fee simple Title Holder on next page(if different E-Mail:
from the 0*ner listed above) State or County License: CGC1508417
if value of construction is$2500 or more,a RECORDED Notice of Co—mmencement is required.
I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone: !
FEE SIMPLE TITLE HOLDER: NNot Applicable i BONDING COMPANY: Not Applicable
I Name: Name:
Address: I Address:
City: City:
Zip: 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 CountyyI 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,
accessary strucCures,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 o orney before
commencing1wor recordi Notice of Commencement.
i Signature of / ent/Les e Signature oPFLORI
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STATE OF FLORI STATE OF
j COUNTY OF 5L COUNTY OF 51
Theleoing instr meet was�cknowlecla before me i The forgoing instru grit was acknowledge ore me
th s 5'fay of_ 20 y this Vday of c i 20Dwby
IPeter Cafaro III • Peter C3(3ro III
(Name ofr a acknat ging) i (Name of person ac 0 gin I
j (Signature of Notary Public-State of Florida) II (Signature ofNotary Public-State of Florida j
,{ Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identificiation Produced Type of Identification Produced
Commission No. Se I Commission No.
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oOK BocoaK
.' Notary e ct Honda+ , ��� Notary Public •Stale of Florida
L_ •• h`c - y_Cj0M �.1 -. - mm [.NuCB_4f8r: Com176869 .E ° Commiss.on s EE 176889
7 oni�` yP.evised 0T/ j/_0 Bonda7 hl Notary Assn """ Bonded Through 1,:,anal Nolary Assn.
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