HomeMy WebLinkAboutBuilding Permit App - Hayden ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 6( Permit Number:
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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
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 'J `t 0�-- kI / A
Legal Description: A;Vt�mt PA v k Z. "�r-
Property Tax ID#: L0 - 024(A::::" C'�10d 1
'Z Lot No.
Site Plan Name: 4--1 V40 Block No. �
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
ski(( ?L.•. �c�-�c+ort
CONSTRUCTION INFORMATION:
Additional worK to e pertorm6d under this permit-check a apply:
HVAC Gas Tank �Gas Pip
_ ing In Shutters �Windows/Doors
❑
Electric 0 Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ �JlDo Utilities:cnSewer ElSeptic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name todvt�-�'ti Ot^� Name: Peter ACafaro III
Address: 32A Awe Company: Lowe's Home Centers;LLC
City: D,,k s� �-Kc'G State: fit-- Address: P.O.Box781993'
Zip Code: 3 L((? *S-Z Fax: City: Orlando State: FL
Phone No. -7 7-- 3 1749 Zip Code: 32878-1993 Fax:
E-Mail: Phone No._ 71-Z - y 1 g - 35-`I 1C
Fill in fee simple Title Holder on next page(if different E-Mail: +Qg1_ 1W-_Am.,'s $;I'- has eo.h
from the Owner listed above) State or County License: CGC1508417
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW I F{1 ��.
DESIGNER/ENGINEER: _ of Applicable MORTGAGE COMPANY: _ t 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 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 ma esult in your paying twice for
improvements to your property. A Notice of Commencement must be r ord d and po_stQd on the jobsite
before the first inspection u intend to obtain financing, consult wi lend r or atto ney before
commencing work or reg6rdindyour Notice of Commencement.
yll�v A� V V s
Signature of er/Lessee/Contractor s gent for Owner Signature o Contractor/License Holder
STATE OF L RIDA STATE O LORIDA
COUNTY F o ange COUNTY O Orange
The for of g in rument wa acknowledged before me The forgoi nstrument was acknowledged before me
this54 ay o 20'?A—by this PUN day of .5tp} 20 Z,l by
Peter a Cafaro L Peter A Cafaro III
(Name of person acknowledging) (Name of person acknowledging)
ignature)Kcown
Notary Public-State of Florida ) ( ignature blic-S of otary Putate Florida )
Personally x OR Produced Identification Personally Known X OR Produced Identification
Type of Identification Type of Identification Produced
�r► Notary Public State of Florida
Commission No. _° I' Kari M Et oni Commission No. Notary 6teo►Florida
MI- Fy Comr lisst FF 981647 : Kari M Riccaboni
of w
Expires 05I26120� y . My Commission FF 981847
aw
Revised 07/15/2014
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