HomeMy WebLinkAboutBuilding Permit Applicaiton ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: lC jibl 15 Permit Number: IMO - OW
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Building Permit Application k� ro?o1e
Planning and Development Services StOs,
Building and Code Regulation Division 4004,0_0,04
2300 Virginia Avenue, Fort Pierce FL 34982 Qo���'hh
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line 'p o' r s
PROPOSED IMPROVEMENT-LOCATION
Address: 10 "J 0 Ce•AN Y
Legal Description: W A•O w►. I I V► l i', I�e C,, rlao tit n, I �-{
to - OOLl - (0
Property Tax ID#: u!J l 1 - stat -'LO � Lot No.
Site Plan Name: Ci &'o 1 1 /h -+ S Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK.
CONSTRUCTION INFORMATION. ' .
Additional work to be performed under this permit-check all h apply:
n
I (HVAC _Gas Tank Gas Piping _Shutters ,l Windows/Doors
0 Electric 17Plumbing Sprinklers _Generator _Roof Roof pitch
Total Sq. Ft of Construction: S . Ft. of First Floor:
09
Cost of Construction:$ t 3 (o r Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE: °- ,.. CONTRACTOR:,
Name 2/t.1 t4A✓✓i S. Name: Peter.A Cafaro Ill. ,
Address: I L&S.I. S; O c.ka+.., DY Company: Lowe's,Home Centers, LLC
City: ---S4-3s*. -ac_J State: `f— Address: P•O.Box 781993 =
Zip Code:.3.4 9 5-:-7. ., . Fax: City: Orlando State:FL
Phone No. ZD 3 - Z 17 - 3(0 3 ti Zip Code: 32878-1993 Fax:
E-Mail: Phone No.
Fill in fee simple Title Holder on next page(if different E-Mail:
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:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY:
Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone: `/
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: )1 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 represu
sentation that is granting a permit will authorize the permit holder to build thesubject 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 r in your paying twice for
improvements to • propert i Notice of Commencement must be recor ed End post-. o' the jobsite
1 before the first irspec ion. I ou i tend to obtain financing, consult with I der or an . • orney •efore
commencing work or eco •ing yo r Notice of Commencement.
s
Signature of O'ner/Lessee/Contractor as "':ent for Owner Signature of Co j actor/License Holder .
STATE OF F •RIDA I STATE OF FL RIDA
COUNTY 0 i•range COUNTY OF r nge
The fsligoing i .trument was acknowledged before me The forgoing in ument was acknowledged before me
this day ,. C_Xfre. ‘,..... . , 20 12, by this++ day o Qa'tztev 20 /8 by
Peter a Cafaro IIIA- Peter A Cafaro III
• (Name of person acknowledging) , (Name of person acknowledging)
1 t IL 1 I
(Signatu o Notary P lic-State of
2nofotLPubateonda )
Personall nown _ x OR Produced Identification Personally Known X OR Produced Identification
Type of Identification Produced !_ _ _ _ Type of Identification Produced
xY o, Notary Puud�ic$$l�aate of Florida
Commission No. :' '� Kari M Fsi�@86bni Commission No. .00."w,, I'pblic state of Florida
My Commission FF 981647 Kan M icsion FF
•
Expires D5!2E!2020 My Commission FF 981647
�P AP F p e 0 28202
as a�
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW , REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
•
INITIALS