HomeMy WebLinkAboutBUILDING PERMIT APPLICCATIONALL APPLICABLE +INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: IZIZ'.7'L u 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 Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 118 N L-M+,5 Q (" a
Legal Description: IJt-rr(6`1�1 (cam-%) �1N
Property Tax ID #: 4150 Z - S'o I - 03 F, 4 OC>0 -la Lot No._
Site Plan Name: Block No.
Proiect Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
�_A_w i < 7_1 J� LAe_sip
CONSTRUCTION INFORMATION:
Additional work to jeper orme under this permit— check a apply:
E]HVAC lJ Gas Tank Gas Piping _ Shutters 121 Windows/Doors
11 Electric 0 Plumbing ❑Sprinklers Generator a Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ ?-60co `
Sq. Ft. of First Floor: _
Utilities:Sewer 0Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
Name: Peter A Cafaro III
Address: j Ol'�1 Iy�T fI�'�✓''J
Company: Lowe's Home Centers;_LLC
City: `YwjL_&� 0--,f State:_
Zip Code: 3'n�(� S Z Fax:
Phone No. / S N' ��ib-' 9 S5-7
Address: P.O.Q_ox 781993'
City: Orlando State. FL
Zip Code: 32878-1993 Fax:
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: L jur - CD O%
State or County License: CGC15 8417
if value of construction is 52500 or more, a KtcUKutu Notice or commencement is requires.
SUPPLEMENTAL CONSTRUCTiQt4.UEN tAVi
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: X.&ot 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 may4esult 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 re rdin our Notice of Commencement.
Signature of or/Lessee/Contractor
STATE OF L RIDA
COUNTY Fa
nt for Owner
The forgot
g in rument was acknowledged before me
this Z3 ay o L - 20 : by
Peter a Cafaro I)( --
(Name of person acknowledging)
tr"�' "J1 ( I , - 1,
ignature7Ko�wn
otary Public- Sta e of Florida )
Personally x OR Produced Identification _
Type of Identification
vs• ►y.- Notary Public State of Flonc
Commission No. _� `r Kiln M�oni
My Go tss FF 981647
+; s�' Expires 05128/20U
Revised 07/ 15/2014
Signature ACLontra ctor/License Holder
STATE ODA
COUNTYOange
The forgoit)nstrument was acknowledged before me
this �� day of !)L,C' , 20 C by
Peter A Cafaro III
(Name of person acknowledging )
ture of�Votary Public- State c}f Florida )
Personally Known x OR Produced Identification
Type of Identification Produced
Commission No. Y Notary 45t%dtltate of Florida
? Kan M Riccaboni
y ; _ My Commission FF 981647
s
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