HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED (� L�
Date: Permit Number:1—f 0 ` '0u�`o
Building Permit Application
Planning and:Development Services
Building and Code Regulation Division
2300 Virginia,Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
J�PERMIT-rYPE:
ij PROPOSED,IIVIPROVEMENTLOCATION- _
Address: "O-j r
Property Tax ID#: 'bY10 SPZ'UTZ- 003-5 Lot No. Is
Site Plan Name:tt�C.( Cfi�f® Block No.
Project Name:
Wi4LED`DES'CRI.PTION�:O'F°WORK.
'. s $.r. FORMA.:,,,
CONSTRUCTION INTION:
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank —'Gas Piping _Shutters Y Windows/Doors
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
;Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ �i i?�3 io Utilities: —Sewer —Septic Building Height:
,OWN ER/LESSEE t M 'CONTRACTOR
Name gda:��_� ��(.i..4, Name:PeterAbafaro Ill
Address: IaU1 :�i� ��Ii- ter. Company:
Lowe's,Home Centers.
City: FO r�- 1�i�.fCe-`- c' State: Address:PO Boz 781993:•
Zip Code: :���.CI �� Fax: City: Orlando - State:FL
Phone NoJ
4.. Zip Code: 32878 Fax:
E-Mail: i Phone No 772-281-8912
Fill in fee simple Title Holder on next page('if different E-Mail rebecca@permitgroupfl.com
from the Owner listed above) State or County License CGC 1508417
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIENIAW]INFI
ORMATION
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: 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 IMPROVEMEN YOUR PROPERTY. A NOTICE OF COM NCE T UST BE RECORDED AND
POSTED ON THE JOBS E BE RE THE FIRST INSPECTION. IF YOU 1 D OBT N FINANCING, CONSULT
WITH YOUR LE E O AN ATT RNEY BEFORE RECORDING YOU N ICE O COMMEN EMENT."
y "I V V
Signature of Ow a Lessee/Contractor a Ag nt for Owner Signature of ontractor/License Hold r
STATE OF FL RI A STATE OF LORIDA
COUNTY OF ange COUNTY IF orange
The forgoing in rum nt was acknowledged before me The for in instrument was acknowledged before me
this day of 20A by this d of r1tolr"k ,20]3 by
Peter A Cafaro III Peter A Cafaro III
Name of person ma Ing statement. Name-of person making statement.
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Type of Identification
Produced Produced
rid
Cigna re of N try ic- i7$��fck�e (S gnatu of ti c K r tJl il,lvi �°
My Commission FF 9,81647
981647
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Commission No '�or'ti°~ Expires 051281205 al Commission No y�� eP Expires 051281202ommission E eat)
Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.