HomeMy WebLinkAboutBuilding Permit Application - i
ALL APPLI 4BLE INFO MUST BE COMPLETED FOft APPLICATION TO BE ACCEPTED d r
Date: , ( l I Permit Number:
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Building Permit Application
Planning dna Development Services
Building and d 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
?ice +.sem
Address: i 6t 3 9 LJA y
Legal Description: TO-0 Z- %-r Jk,, +_ Q_L__-*_JJ,JZ= X1'"1
Property Tax ID#: 33?--1 - �'1 - C»S 1' Gov - Lot No. 4-7 '
Site Plan Name: 5&C>CJ g /,)6.^ I Block No.
Project Name:
Setbacks I Front Back:- Right Side: Left Side:
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itiona �uvor to a orme un ert is permit=c ec a apply:
❑HVAC ElGasTank Gas Piping _Shutters windows/Doors
®Electric Plumbing 0 Sprinklers FIGenerator Roof
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Total Sq. Ftlof Construction: Sq. Ft.of First Floor:
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Cost of Coni truCtion:$ � Utilities: _Sewer LJ Septic Building Height:
13
01 a
Name O!i Name: Peter A Cafaro III
Address:.-f-44 3 CZ Company: Lowe's Home Centers, LLC
City: 5�t- L�:.�;.� State: �L Address:
P.O. Box 781993
Zip Code: I3'-191,L,0 'Fax: City: Orladno State:FL
Phone No.j..�Z Z' `i " �� �'t Zip Code: 32878-1993 Fax:
_ 772- Lf I
E-Mail: Phone No.
Fill in fee simple Title Holder on next page(if different E-Mail: TP Com_L P44�-I*S Q yakao.coo-
from the O*ner listed above) State or County License: CGC150M17
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If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY:1 XNot Applicable
Name: Name:
{ Address: I Address:
{ City: State: City: State:
Zip: Phone: Zip: Phon'el
FEE SIMPLE TITLE HOLDER: 'Not Applicable BONDING COMPANY: Not Applicable
Name: I Name:
Address: Address:
City: City:
I Zip: Phone: Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do th!e 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 land 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 e Signature o Contra r5-6se Hol
STATE OF FLORI STATE OF FLORI A f
COUNTY OF sic COUNTY OF SLC _ I
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The fo ening ins[rumert was gcknowled a before me I The fgrsoing instrumgnt was'lacknowledge P ore me
this�'SAfay of 20y this `srday of Y �/ 20y
���777
Peter Ca[aro 111 Peie,cafaroIII
I (Name of p s,ari'ackno ging) - I (Name of person ac agtn
(Signature of Notary Public-State of Florida) (Signature of'Notary Public-State of Florida)
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Personally Known X OR Produced Identification Personally Known ' OR Produced Identification
Type of Identification Produced 11 Type of Identification Produced I
Commission No. , . (Sem l)rCH B0CG0K Commission No, ffi
800001(
=� Zy Notary Public •Statc of Florida _ a � Notary Public -Slatc of Florida j
• - Comm G Ques A4er i-iB '`�' Y Lamm--Fxt;.
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Commission tt EE 176869 •' commission .4 EE 176869
Revised O7/15120 4 Bonaea Trimuon National Notary Assn Bonded Tbrou9n,\,;,ono!Noluy Assn.
FREVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION, SEA TURTLE I MANGROVE
COUNTER REVIEW REVIEW _�—REVIEW
REVIEW ' REVIEW REVIEW
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DATE
COMPLETED
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