HomeMy WebLinkAboutBuilding Permit Application �3 i �
� i
ALL APPLtIC�A(BLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED r
Date: 't I I W( n Permit Number: I O [V
.C(:)LlNTY ::
Building Permit Application JUN ;
Planninga d Development Services
In PEHi':AI1T{NC
Building a d Code Regulation Division
�. St. Lucieunty { L
2300 Virgi►io 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
Address: SA w4-E WAq
Legal Description:
Property Tax ID#: Z,Lo 'sem' O(oC7 7 - OOC7-� Lot No. g
Site Plan Name: �fit5; Block No. f Z
Project Name:
I •
Setbacks lFront Back: Right Side: Left Side:
- itiona rktObenerformed under tis permit=check all=ap-p-ly:
I VI
OHVAC Gas Tank []Gas Piping OG*enerator
Shutters ❑Windows/Doors
®Electric Plumbing Sprinklers O Roof
Total Sq. Ftiof Construction: S . FtFt.of First Floor:
Cost of Construction:$ 'Utilities.L_!Sewer, Septic Building Height:
ffam
Name b i� Name: PeterACafaro III
Address:.-•.I e>+�- 6" Company: Lowe's Home Centers, LLC
City:, State:/z- Address: P.O. Box 781993
Zip Code: 1S,if q.%-t ' ''Fax- City: Orladno State-FL
Phone N.a.i- -1 0-. 42_-8,767-4 Zip Code: 32878-1993 Fax: .
{ Z - Y1 9-3(o9S
E-Mail: � Phone No. 77
Fill in fee s�mple Title Holder on next page(if different E-Mail: �P is_t_p'6rhw �s��/�4'r�•c..�
from the Owner listed above) State or County License: CGC1508417
,
If value of construction is$7500 or more,a RECORDED Notice of Commencement is required.
MARTIN COUNTY BUILDING DEPARTMENT Print Form
900 SE RUHNKE STREET
STUART,FL 34994
(772)288-5916
FAX(772)288-5911
MARTIN COUNTY BUILDING DEPARTMENT
SHUTTER SCHEDULE
APPROX. APPROX. HEADER
I.D. OPENING APPROX. ANCHOR REINF.
NO. SIZE SHUTTER
HEIGHT SPACING REQ'D. REMARKS
(W X H) YES/NO
37" X 63" 45" 71" 12" NO EXAMPLE
I Z N�
2 72'x-l zz 72- /Z Z
3 -7B X112 78 I�Z l2
4 a y j. 1 cif �' 12-
1 15'9x cn9 59� -t!;- 6,17. T Ip�Q.s �c
6 Lf 3 Y-32 '13.Z5 37-.'�— 10
7 6j4 d( (6 6� (off. 12.
9 3v�ctog 3v.Z� (04, s
10
11 3o � 'H5
t0
12 90 A 49 80 Q4.� to
13 1 1 g 99 1 1 8 « �,
14 (1q tq, 11 q
15 gZx b2 �2.Z-L 1oz.-5-
16 3 I3 3c> (06).!;, I Z S
17 It if
18 4 15-
Ig ZLfY� Z8 Z`t Z n
ice: : R
SUPPLEMENTAL CONSTRUCTION LIEN LAIN INFORMATION: `S
DESIGNER/ENGINEER: _Not Applicable i MORTGAGE COMPANY: Not Applicable
Name: I Name:
4 Address: i Address:
I City: State: I City: State:
Zip: Phone: — Zip: Phone:
i
FEE SIMPLE TITLE HOLDER: YNot 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 thepermit 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 torney before
commencingwork, record i ; r Notice of Commencement. _
1
Signature of r/ ent/Les Signature o Contra r/L' rise Hol
STATE OF FLORID STATE OF FLORI A
COUNTY OF SLC COUNTY OF SLC
The re ing instru , was a knowled ed efore;me ! The f going instru nt was acknowledge ore me
this�lay of ��"�"� 20 uy ! this ay of rr n 20 'by
Peter Cafaro III - i Petr Ca'mo Ili
(Name of p ;o ackno�—�gin�gg - 1 (Name of person ac agtn
(Signature of Notary Public-State of Florida) (Signature of lNotary Public-State of Floridan
Personally Known X OR Produced Identification Personally Known " OR Produced Identification j
Type of Identification Produced Type of Identification Produced 1
I 1
Commission No. (SeCH 80000K Commission No. BOCOOK
! Notary Public -State of Florida Notary Public -Slate el Florida
•� '.
-- --— --- �kY_CotIIm_Facpicts-Wtar-i-?fltfi --------- re '_SAy rnm 1v— •r 7 2B i8-
jFo 1,�,:` Commission#EE 176869 E p Commiss�un EE 176869
r
Revised 07/15/201 Bonded Tnrcuatl National Notary Assn Bonded Tnrou3n •,:;ana'NolaryAssn.
0
REVIEWS FRONT ZONING ( SUPERVISOR PLANS T VEGETATION SEA TURTLE I MANGROVE
i COUNTER REVIEW 1 REVIEW REVIEW REVIEW JREVIEW REVIEW
DATE l - — -- -
RECEIVED f
DATE
COMPLETED 1