HomeMy WebLinkAboutBuilding Permit Application �J
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I
Date: ' Permit Number: ���"�
Q
100
F
Building Permit' Application
Planning and Development Services G0
/0°04 O�
Building and Code Regulation Division COo/���J
2300 Virginia Avenue,Fort Pierce FL 34982 PhE
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMITTYPE: -�
PROPOSED IMPROVEMENT LOCATION ".`
Address: Q 0 ('�(Ieo .ry r "C
Property Tax ID#: �/SrI`.+L"70J- C30[� -C ��� Lot No.
Site Plan Name: AOMM-a.4-� Block No.
Project Name: 'grj\ Pn
DETAILED DESCRIPTION OF WORK
�.n . •�� �..�Y
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit-check all that apply:
_Mechanical _Gas Tank —Gas Piping _Shutters Windows/Doors
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ ;,2,14�,� Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: .' ,CONTRACTQR:
Name SU5'�Y1 A(XAk,&W(\ Name:Peter Cafaro III
Address: ti GOB. S C�(,41d�f1.` r". SC Company-Lowe's•Home.Centers
City: �z.V� n �a2;6` :" " Stater Address:.PO Boz 781.993,
Zip CodeFax:,, City: Orlando State:FL
Zip 32878 _
Phone No:;361. �- �R:q..S . Zi Cod Fax:,
E-Mail: 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 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 FAI URE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMP VEMENT TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON T E J B SIT�BEFO E THE FIRST INSPECTION. IF YOUn1D TO IN FINANCING, CONSULT
WITH YOUR NDE OR N ATTO NEY BEFORE RECORDING YOUR NF C ME CEMENT:"
V V -/-* V /--,-\
Signature of 0 ner/Lessee/Contractor as ge t for Owner Signatur of Contractor/Licens Hol Jer
STATE OF L RIDA STATEO FLORIDA
COUNTY O o nge COUNT OF Orange
The forgoing'nst ument was acknowledged before me The forg i Instrument was acknowledged before me
this day of 20_ by this d y of 20_ by
Peter A Cafaro III Peter A Cafaro III
Name of person making 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
r
(Si nature of N - �dP ( gnature of t51ta19`Pt� �s
Notary Public State of Florida 'U* Notary Public State of Florida
Commission No = Kari M Riccaboj� = Kari M Riccaboni l)
mission Rp�ll)oa7 Commission Nd.• Seal
y r_ } u fission FF 8164
Expires 05128!2020 '?Q�'no`' Expires 05128/2020
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 2/7/19