HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1`� Permit Number: . CO —
RECEIVED
Building Permit Application MAY 0 9 1019
Planning and Development Services
Permitting
Buildingand Code Regulation Division S. Lic:ie County
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION-''
Address: - $yo 6(?,yf4 MIte, Gl
Property Tax ID #: �L333 — 121— O cno — C)00 — 1 Lot No. I
Site Plan Name: Block No.
Project Name: Co--f 400
DETAILED DESCRIPTION OF WORK.
1 r, 576? 1 (gio V i n - l Zm,rJr,� r��
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit — check all that apply:
_Mechanical _ Gas Tank _ Gas Piping —Shutters _ Windows/Doors
Electric
Total Sq. Ft of Construction:
Plumbing _ Sprinklers
Cost of Construction: $ 2�l -70-0 "
Generator Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:.
,;CONTRACTOR:
Name Te_�bto C6Jt6nName:
Peter Cafaro III
Address: `3Y1 (J C (2tFf,Y1 fYl�i'e, 12e1
Company: Lowe's Home Centers
City;..-c-� 1 ie�rc' ` State: G(�
Zip Code:' 34A% 45, Fax."' < ':
Phone No. -7� oZ -961 �.& E-3:%
PO Box 7.81993
Address:..: ,
City: 'Orlando ` State: FL
Zip Code: 32878 Fax.
Phone No 772-281-8912
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail rebecca@permitgroupfl.com
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.
I
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: 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 IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SIT BE RE THE FIRST INSPECTION. IF YOU INTE TO OBT FINANCING, CONSULT
WITH YOUR LENDER OR N ATT RNEY BEFORE RECORDING YOUR NOTIC OF COM NCE ENT."
n /
I / V A
Signature of Owifi r/ Lessee/Contractor s ent for Owner
Signature of Con actor/License Holder
STATE OF FL RDA
STATE OF FL IDA
COUNTY OF ran
COUNTY OF a ge
The forgoing in tru ent was acknowledged before me
this � day o 20 by
The forgoing in tr ment was acknowledged before me
this day f 20J� by
Peter A Cafaro III
Peter A Cafaro III
Name of person m ing statement.
Name of pers n aking statement.
Personally Known x OR ProIdIdentificaflon
Kno n x OR Prod u tification
Type of Identification
Type of Identification
Produced
Produced
L:,Personally
ILL
(Si nature of Notar eps ter.•.
(Si nature o Not ry P b l - State of FYbrida )
Notary Public State of Florida
Commission No. ;p Kari M Riclji
y _ , y Commission FF 981647
?o� mac! Expires 05/2812020
Commission No. a`µrh'i' NotaryPubljd$a�ofFlorida
ari M Riccaboni
My Commission FF 981647
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
S A
E
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
PLANNING & DEVELOPMENT SERVICES
BUILDING & ZONING DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 FAX 462-1578
CHANGE OF CONTRACTOR, SUBCONTRACTOR OR CANCELLATION OF PERMT
PLEASE SELECT ONE OF THE FOLLOWING:
CHANGE.OF CONTRACTOR — Change of Contractor is to be signed and notarized by the property owner,
and the new contractor of record for the current permit. A new permit application must also be completed with new
contractor information and 'signature. A new Notice of Commencement must be filed in the new contractor's name
for job values greater than $2.500 ($7,500 if A/C Change -out). A recorded copy must be submitted prior to
commencing any work. There is a $50.00 fee for the Change of Contractor.
CHANGE OF SUBCONTRACTOR — Subcontractor changes are to be completed by the general contractor.
The new subcontractor must fill out a Subcontractor Agreement Form. There is a $50.00 fee for the Change of Sub -
Contractor.
XX CANCELLATION OF PERMIT — The cancellation of a permit is acceptable only if no work has been done.
Cancellation of permit is to be signed and notarized by both the owner and qualifier of record. There is no fee for
cancellation of the perm, _J>k_q� c-tmV+ I e-,mjo IG1FF -7q4" p4ve, All Y'�a
Date- �1 V1 Permit Number: A ��;7' 0 ay
Site Address: ' XX STUD `5hj e.n
PETER CAFARO
Original GC, subcontractor or owner/builder
License CGC1508417 SLC License
N/A State License N/A
New GC, subcontractor
Reason for Cancellation CUSTOMER CANCELED INSTALLATION
SLC License N/A
The undersigned does hereby agree to indemnify and hold harmless St Lucie Cou y, its officers, agents and employees from all
costs, fees or damages arising from any and all claims of action for any reason, icI, may arise as a result of this change of
contractor/st bcontra for o ancellatiot f pervvitif. A permit cannot be cancel d if oAACTOee(]n
performed.
'N01'ATI E C OWNER (or ow er uildlerl) SIGNATUR G .NERAL. COnew GC, as applicable)
PRINT NAME tee} IbaXi CQ rIT�)Yi PRINT NAM PETER CAFARO
State of Florida, County of St. Lucie County
The following instrument was acknowledged before me this
day of :Yu to f— , 20 1 -1, by
P.i916y,0-` C- NLL_M 4vho is personally knomm to me
or who lkas produced ��- �' �' as ID.
Signature of Notary Date
State of Florid, Cowity of St. Lucie County
'i he following instrument was ac v edged be lie this
'l day o1' ` _0, by
v o is ersonally kno\ to
n i iced % as ID.
v �Y P4 N Public State Of Florida
_RICHARD BYRNE _° i M.Ricc2boni
Revsed;y ;_ My Commission FF 981647
_°�� "•46 MY COMMISSION #FF916140 +� Expires 0512812020
f EXPIRES: OCT 16, 2019
Bonded through 1st State Insurance