HomeMy WebLinkAboutBuilding Permit Application i
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: Numbe;�(D0
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
PERMIT TYPE:
PROPOOSED IMPROVEMENT LOCATION
Address: LIB CjI° cSU'(1 \�l
Property Tax ID#: l-1 U�- &r4 G:2?,q =C=-7 Lot No.
Site Plan Name: Block No:
Project Name:--��,.1 P
DETAILED-DESCRIPTION.OF WORK
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CONSTRUCTION INFORMATION:
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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: $g, 9O Utilities: —Sewer _Septic Building Height:
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OWN ER/LESSEE CONTRACTOR: I
Name_T>h Jk T Name:Peter Cafaro III
Address:,. J770G,_, bvek Company:Lowe's Home Centers
City: C=rn�� t�'i�c. Stater Address 'P,0.Box.78.1993
Zip Code: ql�%� .,Fax: City: Orlando State:FL
Phone N9.l-?X .`374 [,2.91 Zip Code.: 32878 Fax: II
E-Mail: Phone No 7.72=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
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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.
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SUPPLEMENTAL CONSTRUCTION LEEN LAW MFORMATION..
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 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 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 M ESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCE�MMENJEMENV'
TST BE RECORDED AND
POSTED ON THE JOB S EFORE THE FIRST INSPECTION. IF YOU INTEND TBTN FINANCING, CONSULT
WITH YOUR LENDER O AN ATTORNEY BEFORE RECORDING YOUR NO E F C
\n ./ � V V
Signature of 0 ner/L s e/Contract as A ent for Owner Signature of ntractor/License Hold r
STATE OF L RIDA STATE OF RIDA
COUNTY Fo nge COUNTY F range
The forgoin inst u ent was acknowledged before me The forgoin in ru nt was acknowle ged before me
this 9-0 da of 202) by thisSO' da of � ,20a0by
Peter A Cafaro III` F Peter A Cafaro III
Name of pers 1n aking 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
Signature of otary Public-State of Florida) Signatu of N. riR48
vaY icy Notary Public State of Florida
Commission Nosy .►�Y°�� Notary PublicStf-"l¢lorida Commission No :� � Kari MRiccabonS
> Kan M Riccabon) Cornr-ission Ff�5�t547
Q y o-8 Expires 05/2812020
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My Commission FF 981647
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OF FL x.
REVIEWS W Z I _S_a4 I S 0 R PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19