HomeMy WebLinkAboutBUILDING PERMIT APPLICATION ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: j 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 �C
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description: ot,L ?p V, ( vkV% Z 1k
Property Tax ID#: 341 9 ' 610 00(0 7 - O ors- 61 Lot No. �l
Site Plan Name: y4ee-1 'f)-.40.A0S0J Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
p,.C, o o+c
CONSTRUCTION INFORMATION: !
Additional work to e er orme under this permit-check a app y:
F1HVAC F1 Gas Tank Gas Piping _Shutters Lo Windows/Doors
11 Electric 0 Plumbing Sprinklers FI Generator El Roof Roof pitch
Total Sq. Ft of Construction: ' S Ft. of First Floor:
Cost of Construction: $ 1 �oota, °' Utilities:cnSewer 11 Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name p�(hJNetloao•u Name: Peter Cafaro III
Address: 31-1 �V�,,r,,, �w // Company: Lowe's Home Centers;LLC
City: P,, State:w Address: P.0.E3ox 781993'
Zip Code:3 H'A SZ Fax: City: Orlando State: FL
Phone No. Zip Code: 32878-1993 Fax:
E-Mail: Phone No. -1Z2- L08 - 3(v4 S
Fill in fee simple Title Holder on next page(if different E-Mail: 4"ga )6n!!to
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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 INFORMATION:
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:
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 rn 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
commencingwork or re rdin our Notice of Commencement.
Y//"-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 was acknowledged before me The forgoi nstrument was acknowledged before me
this V_ ay o 20'Z.Z by this day of — +v 20 TX by
Peter a Cafaro I 1 Peter A Cafaro III
(Name of person acknowledging) (Name of person acknowledging)
J.
ignature)K �own
Notary Public Sta e of Florida ) ( ignature of otary Public-State FloridLa )
Personally x OR Produced Identification Personally Known x OR Produced Identification
Type of IdentificatioF"Ity
� Type of Identification Produced
^ Notary Public State of Florida
Commission No. Kari M�0ni Commission No. Yo NotaMy Com tsst FF 981847 ry dta Mate of Florida Expires 05/2812OU : Kari M RiCcaboni
taw -_ My Commission FF 981647
aw
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS