HomeMy WebLinkAboutPrince appALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Q ! � , �' Permit Number:
Date: _�
--
J` _ w
•
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
Avenue, Fort Pierce FL 34982
2300 Virginia
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line �I.1wr�✓S
PROPOSED IMPROVEMENT LOCATION
Address: e A,.,kIkW-�
Legal Description: �A !:E~
Z�Z- t C�3Z. per•
Property Tax ID #: '
Lot No.
2 _ ,�.�W�
Site Plan Name: �.7�'�
Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
[iDCETP LED DESCRIPTION OF WORK:
CONSTRUCTION tN-FORMATION#: -..._..,
Adclitiona wor to re orme un er t is permit - c ec a app Y.
❑Gas Piping Shutters windows/Doors
— Gas Tan ❑
�HVAC k
L� Generator Roof
Roof pitch
Electric Plumbing Sprinklers
Total Sq. Ft of Construction:
S Ft. of First Floor: _
Cost of Construction: $ �t �� � utilities: _ Sewer 11 Septic Building Height:
OWNER/LESSEE:
Name '�• ' '
Address:
City: State:
Zip'Code: 3u9 N7 Fax:
Phone No. 1 2 9
E-Mail: - -
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name: Peter A Cafaro III i
Company: Lowe's Home Centers; LLC
Address: P.O.Box 781993
City: orlando State: FL
Zip Code: 32878-1993 Fax:
Phone No. __7, T
E-Mail: 4.p9T_ ` rr"J-3, 1/� —'o.'^
I CGC1508417
State or County License: —
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLE�t5
41
DESIGNER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY:
Not Applicable
Name:
Name:
Address:
—
Address:
City:
State:
City:
State:
Zip: Phone:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
of Applicable
BONDING COMPANY:
_Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
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 structure. with
w with your Home Owners Owners
Association aondrrev rules,
bylaws ur deed for any restrictions nts that wh which restrict
may a. prohibit such
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 ma esult in your paying twice for
improvements to your property. A Notice of Commencement must be r ord d and po d on the jobsite
before the first inspection u intend to obtain financing, consult wi lend r or atto ney before
commencing work or reg6rdinayour Notice of Commencement.
Signature oAFO
er/Lessee/Contractor' .gent for Owner
STATE OFRIDA \�/�
COUNTYnge
The for gQing in rument was acknowledged before me
this _�� ay o 'StD� 20 Zo by
Peter a Cafaro Ikl
(Name of person acknowledging)
G
ignature7K�o�wn
otary Public- State of Florida )
Personally x OR Produced Identification
Type of Identification
r ►ems Notary Public State of Flonda
4R Kari Mf�oni
Commission No. MY Co ,ss FF 981647
+r' Expires 05128/2020
Revised 07/15/2014
Signature olcontractor/License Holder
STATE O LORIDA
COUNTY OF Orange
The forgoi4)nstrument was acknowledged before me
thi41 � day of 20 ?O _ by
Peter A Cafaro III
(Name of person acknowledging )
re of otary Public- State df Florida )
Personally Known x OR Produced Identification
Type of Identification Produced
Commission No. _ r Notary dw5gcl6te of Flonda
? Kan M Riccaboni
e My Commission FF 981647
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