HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED.
Date: �O• IJ i Permit Number: '
REL&CIVELO
Building Permit Applicatio JUN 12 2018
Planning and Development Services
Building and Code Regulation Division Permitting Department
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial RESidebmiaie gunty, FL
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
'PROPOSED IMPROVEMENT LOCATION
Address: 56 1 -7
Legal Description: txPt� �yE� �CS'� Zl�
Property Tax ID#: tfO2^ (p09 - Q 2S '1 000 Lot No. 3�
Site Plan Name: Akp, a JAZ_ Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
rr ,
DETAILED RES'CRI,PTION'hOF WORK "
CONSTRUCTION..I N FORMATION
Additional work toa Dertormed under this permit—check all appy:
HVAC Gas Tank 0Gas Piping _Shutters -1 Windows/Doors
Electric ❑ Plumbing []Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ ��z-Co Utilities:cnSewer Septic Building Height:
0.1NNER/LESS,EE ; CONTRACTOR:>.
Name ��pra, ��A z Name: Peter A•Cafaro III
Address: S$I :.,5 -r -1B(✓a Company: Lowe's Home Centers, LLC
City: State: Address: F'.O.Boz 781993,`
Zip.Code: 141 Eat .. . Fax
City:'Orlando-, State: FL
Phone No. 50 f 329 - loq Zip Code: 32878-1993 Fax:
E-Mail: Phone No.
Fill in fee simple Title Holder on next page(if different E-Mail: �Yillnv-
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.a
DESIGNER/ENGINEER: _ of Applicable MORTGAGE COMPANY: . KNot Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip. Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: of Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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 property. A Notice of Commencement must be r ded an o ed on the jobsite
before the first inspection. If intend to obtain financing, consult wi le der r an att rney before
commencing wor or eco din ur Notice of Commencement.
. _1X/ V V s
Signature of Ow er/Lessee/Contractor, as ge t for Owner Signature of ontractor/License Holder
STATE OF F 0 IDA STATE 0 F ORIDA
COUNTY O Oran a COUNT OF Orange
The f rgoing instr ment was acknowledged before me The for o ng in trument was acknowledged before me
this(�da of ��.� 20��!by this yo �tin4 20 �y by
Peter a Cafaro III-- Peter A Cafaro III
(Name of person acknowledging) (Name of person acknowledging)
ce'z
Signat e o N to y Public-Stat of Florida ) (Si ature of Not ry ub c-State of lc rida)
Personally Ka wn x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification P Type of Identification Produced
=oar 19
_i, Notary Public state of Florida kyr r�� Notary blic11��tate of Florida
Commission No. Kari IA� $boni Commission No. , Kari KAUPePIboni
My Corftmtss(on FF 981647
Expires miss 2020 y r, My Commission FF 981647
ooa ' off' Expires 05/28/2020
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
I