HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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 X Residential
PERMIT TYPE: Door
PROPOSED IMPROVEMENT LOCATION:l
Address: 10310 S Ocean Dr # 409
Property Tax ID #: 4511-515-0037-000-0 Lot No.
Site Plan Name: Block No.
Project Name: Downes
Change out entry door, no size change - Impact - FL # 14569.4
WsmTi , s TIC N I;WEQRMATION:'
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: $ 2,358 _ Utilities: _ Sewer _ Septic Building Height:.. _
0 NEA/E.E �E:
_ CONTRACTOR:
Name Barbara Downes
Name: Peter Cafaro
Address: 10310 S Ocean Dr # 409
Company: Lowe's Home Center LLC
City: Jensen Beach State: _ _
Address: PO Box 781993
City: Orlando State: FL
Zip Code: 34957 Fax:
Phone No. 772-229-0092
Zip Code: 32878 Fax:
E-Mail:
Phone No 772-281-8912
Fill in fee simple Title Holder on next page ( if different
E-Mail rebecca@pemritgroupfl.com
State or County License CGC1508417
from the Owner listed above)
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
Name:
MORTGAGE COMPANY: '-4 Not Applicable
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
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 FO IIMPROVEMENT,5,O YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED TH OB SIT)LI BEFORE THE FIRST INSPECTION. IF YOU INTENR TO OBT N ANANCING, CONSULT
WITH YOU L D ORAN ATTOMYEY BEFORE RECORDING YOUR NOTIC F OM NCEME T."
V V A
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Signature of 0 er/ Lessee Contractor as g t for Owner
Signature of C tractor License Holder
STATE OF F IDA
STATE OF F RIDA
COUNTY O or nee
COUNTY O O n9e
The forgoing �nst m t was cknowledged before me
this%day of 20 L s'by
The fr,�goin inst um t was cknowledged before me
this da of 20 by
Peter A Cafaro III
Peter A Cafaro 1 Ik
Name of pers aking statement.
Name of pers making statement.
Personally Know X OR Produced Identification
Personally Known X OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(S nature of I t
,. Notary Public State of Florida
Kari M Riccaboni
Commission o' CCQQ''1111
scion FF(�8 �647
gnature c
=off °��,� Notary State of Flor �a
Commission Kari M Riccaboni Seal
'pia Expires 05/28/2020
Or,Public
��H do Expires 05/28/2020 FF 98t647
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