HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: I L x-11
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Building Permit Application GIN P 103A
Planning and Development Services
Building and Code Regulation Division QDAMId
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
PROPOSED IMP
,ROVEMENT LOCATION.
Address: ( l EA5-17 , f P_--Q(Z_ AV
Legal Description: S -SLV,3 C-G'T--7
PropertyTaxlD#: 3!40-5I50010-0on-9 Lot No.
Site Plan Name: Block No.
Project Name: "'�()KNE;
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF:INORK , rw
iZEPL-A C 9-S __-LK?ir Cr
C.O.NSTRUCTI'ON.I N FORMATION
Additional work to Te nerformed under this permit-check all appy:
HVAC Gas Tank ❑Gas Piping _Shutters Windows/Doors
Electric ❑ Plumbing OSprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Aa
Cost of Construction:$ Utilities: _Sewer Septic 'Building Height:
OWNER/LESSEE:. CONTRACTOR: .
NameTA 1-5Y -t).175k,-) '�" Name:iPete�A Cafaro-III
Address: -.k 15 ' �7„AlzzGP_''`,AvE'. Company:,Lowe's Home.'Centers LLC'.
City:`7UhT St' L(i(;1l�_'' State:� Address: P.O:Box`781993'.
Zip Code:__D49,�Zr_- Fax,,,,-,' City:"OrlandoState:FL
Phone No. C(-7-294-7q(�f Zip Code: 32878-1993 Fax:
E-Mail: Phone No. 7 i7. ZSt-g�112
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License: CGC15084 7
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN sLAUU INF;t3RMATi�N
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: —Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLEHOLDER: Not 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 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 undergoinga 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 pr ert A Notice of Commencement must be recorded and posted on the jobsite
before the first irl.&pectigh. If yo intend to obtain financing, consult with len o an attorney.before
commencing w rk Nr rVcording tur Notice of Commencement.
V A i V
s
Signature of O n r/Lessee/Contractor a A ent for Owner Signatur of Contractor/License H Ide
STATE OF LOR DA STATE FLORIDA
COUNTY 0 orang COUN OF orange
The forgoing'nstru ent was acknowledged before me The forgoin instrument was acknowledged before me
this Ivy day f 20 Eby this�d of 20 by
Peter a Cafaro III-' Peter Cafaro III
(Name of person acknowledging) (Name of erson acknowledging)
(Signature of Ntary Pu lic-State of Florida) (S gnature701Ntary Pub Ic-State of Ion a )
Personally x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Pr c Type of Identification Pr u e
Y• Notary Public State of Florida Y
Commission No. :°� Kari 49i5 boni Commission No. r°`� NOtary Fjd �tate of Florida
My Commis ion FF 981647 Kari M FSI a oni
Expires 05/2812020 "S : My Commission FF 981647
a w +'�'or nJ 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
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