HomeMy WebLinkAboutBuilding Permit ApplicationALL ArrU%,ABLE INFO MUST BE COMPLETED FOR APPLIf.ATION TO BE ACCEPTED
Date: Permi•t Number:
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• �:���:'�• � •� �W�- �" RECEI V7D APR 0 0 2037 �
Building Permit Application
Planning a�rd DevelopmentServices
._ •Building and Code Regulation Division
2300 Virgrria Avenue, Fort Pierce FL 34982 ` O
Phone: (72) 462-1553 Fax: (772) 462-1578 Commercial Residential JC
PERMIT XPPLICATION FOR: TO Select from dropbox, click arrow at the end of line11 �IN
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Address:I; SZ O H �� n IV-
Legal
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Legal Description: :ji-sp•ft,a (Civet &Sh�&S 1A,,- 4 9 161 V• 8 o Lam'
Properly Tax 1D #:� Z • 1 a - aZSi 2 - oc�y - q Lot No.
Site Plan Name: -dents 6 ��G� �^: e'V Block No. a0
Project Name:
Setbacks I Front Back: Right Side: Left Side:
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Additional
r to je orme under tis permit =c ec a appy:
HVAC L_I Gas Tank ❑Gas Piping OG*enerator
Shutters Windows/Doors
QElectl is 0 Plumbing 0Sprinklers O Roof
Total Sq. Ftlof Construction: SCI. Ft. of First Floor:
Cost of Conl truction: $ �.o Z ' Utilities: 0 Sewer'o Septic Building Height:
Name c4. �"r"��oName: PeterACafam III
Address::.,-1J�ZCk—os; Company: Lowe's Home Centers, LLC
city; � �iExr¢;�.' ' _ State: -9— Address:
P.O. Box 781993 j
Zip Code: lSkdt82 'Fax: City; Orfadno State:;FL
Phone NG, �!! 1??;, -88 2Lr • I �° '� Zip Code: 32878-1993 Fax:
E -Mail: I Phone No.
Fill in fee simple Title Holder on next page (if different E-Mail:�—1 PC t L-9 y.na . �^
from the Owner listed above) State or County License: CGC1508417
if value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
i DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: Not Applicable
Name:
IName:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
- —!- A
FEE SIMPLE TITLE HOLDER: of Applicable
. BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address: i
City:
City:
I 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 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, 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. —
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Signature of / ent/ Les a Signature o Contra r/ ' nse Hol
STATE OF FLORI STATE OF FLORI A
i COUNTY OF sic COUNTY OF SLC
The foreoing instrument was ?cknowled e b ford me The fnraoing instru -gnt was acknowledge ore me i
this�r`J day tel\ 20 tllis�day of An i k 20 by i
of y
Pelef Cafaro III I Pe!:r Ca'arp III I
(Name of p a ai knot r ging) I (Name of person ac ,
,
I (Signature of Notary Public- State of Florida J (Signature of Notary Public- State of Florida j
Personally Known x OR Produced Identification II Personally Known ` OR Produced Identification
Type of Identification Produced I Type of Identification Produced '
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Commission No. ( Fih}fCN BOCOOK i
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"';",`•. Se Commission No. •'""'• BOEEEI
Notary Public • State of Florida �. ? Notary Public SFlorida
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CAc�m�xPue� Mar
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# EE 176864 �,;�Eo, ;��o''Commiss-un .4 6869�'' °�,� '• Bonded TDrou• h ,,. ;;P,eviced U%/ 1 S/_U Sondes T(troud:i Nalional Notary Assn ] ,. ary Assn.
SEA TURTLE MANGROVE
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