HomeMy WebLinkAboutBuilding Permit Application^
ALL APPUCABUE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ( + Oz�
Date: ~l �� (� Permit Number: o�
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Building Permit Application
Planning al�nd Development Services
Building and d Code Regulation Division
2300 Virgipla Avenue, Fort Pierce FL 34982
Phone: (7F72) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line rev'"
Address: ?,2\-1 N S3 ro S'r
Legal Desc jiption: VAr rv%c+4 A E'S-'rAA�% Pow— A L.o-r 1►�
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Property T'x ID #: _N X k -'io 2 - Vy4't - cyp - L( Lot No. -I
Site Plan Name:.(>to Block No.
Project Narj e:
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Setbacks Front Back: Right Side: Left Side:
LOI
i i
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Additional rk to be ne med under tis permit =c ec a app q
I []Gas
0HVAC Tank ❑Gas Piping Shutters a,iWindows/Doors
Electric 0 Plumbing Sprinklers El11Roof
Generator
Total Sq. FtIlof Construction: Sq.Ft. of First Floor:
Cost of Coni truction: $ Utilities: 0- Sewer Septic Building Height:
Name_ 17rt5�ba Name: Peter Cafaro III
.t , t�1. .
Address:: •..iZ'U -•- .- ��3 r..oCompany Lowe's Home Centers, LLC
City:' f e- i State: JE_Address: P•O. Box 781993
Zip Code: I�Jtict''-I L .'Fax: '` City: Orladno State: FL
Phone No. Zip Code: 32878-1993 Fax:
E -Mail: i PhoneNo.
Fill in fee simple Title Holder on next page (if different E -Mail: ?'P G� L p rmi Q_ ✓M^ao
from the O*ner listed above) State or County License: CGC1508417
If value of construction is $2500 or more, a RECORDED Notice of commencement is required. 0 `n
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: -
DESIGNER/ENGINEER: A Not Applicable
Name: _
Address:
City: _
Zip:
Phone:
State:
MORTGAGE COMPANY:
Name:
Address: _
City: _
Zip: Phone:
Not Applicable
te:
FEE SIMPLE TITLE HOLDER: -Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: 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 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 i yo intend to obtain financing, consult with lender or orney before
commencing won recce ig Notice of Commencement.
Signature of/ ent/ Les e Signature o Contra r/ nse
STATE OF FLORI STATE OF FLORI A
COUNTY OF SLC COUNTY OF SLC
The foreoing instrument was �cknowleclpeci before me
this ZjZ' Ay of �� 20 y
I
Peter Cafaro III -
(Name of oti 'kknoa ging) -
(Signature of Notary Public- State of Florida )
Personally Known X OR Produced Identification
Type of Identification Produced
"" ( FYhCH 80000K
Commission No. Se
Wotary Public - State of Florida
Cnnm F--t_,er A4ar-7-?&J_e
Commission
?: k
'•�,;fo�,.��,. EE 176869
Revised 07/ 1-5/20 Bondea T nroua7 Nalional Wary Assn
The �f j�aoing instru nt was acknowledge ore me
thiC.Ggf+�fay of 2otAfty
Peer Cataro III
(Name of person ac gtn -
(Signature ofNotary Public- State of Florida) �~
i
Personally Known ' OR Produced Identification
Type of Identification Produced i
ill
Commission No.
B0C00K�Floridda
Wotary Public - Slate of
COmmIssa- n EE 176869
Bonded Througn %,:iMa NolaryAssn.
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