HomeMy WebLinkAboutBUILDING PERMIT APPLICATION ALL APPLICABLE INFOMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 ( two 1 Z2 Permit Number:
t"I:_J Ji--I NO!
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: C wAy
Legal Description: 0.,.4c, S Cp✓G 5
Property Tax ID#: J4 l Lt_ Zoo . 0 t< 3 Lot No. S
Site Plan Name: L—wODA ��"""� Block No. �Z-
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additional work to e er orme under this permit—c ec a apply:
❑HVAC F] Gas Tank Gas Piping -Shutters Windows/Doors
F]Electric ❑ Plumbing OSprinklers FI Generator II Roof Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction: $ �nj 70 Utilities: _Sewer 0Septic Building Height:OWNER/LESSEE-CONTRACTOR:
Name La r va .>.-9-1-D Name: Peter A Cafaro III
Address: 35 *kAAe5-4?_ �-J4-1 Company: Lowe's Home Centers,LLC
City: 6C P;bit State:_PC Address: P.O.5px 781993'
Zip Code: 341,4L0 Fax: City: Orlando State: FL
Phone No. Q S y- 5-30 ' ( q Lf1 Zip Code: 32878-1993 Fax:
E-Mail: Phone No. 77Z- • YI S'- 3G�9 5
Fill in fee simple Title Holder on next page(if different E-Mail: '�?! ��rn�
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:
)t, 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 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 re rdin your Notice of Commencement.
yl"—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 forgoi g in rument was acknowledged before me The forgoi nstrument was acknowledged before me
this ay o a 20 IA-by this day of 20 ZZ by
Peter a Cafaro I Peter A Cafaro III
(Name of person acknowledging) (Name of person acknowledging)
ignature o Notary Public-Sta e of Florida ) ( ignature of otary Public-State Florida )
Personally K own X OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Type of Identification Produced
Y �Not ���
Commission No. _° Commission No. r
My Com I., FF 981647 Notary f�t�a Mate of Florida
Expires 05/2812OU r Kari M Riccaboni
of a y, My Commission FF 981847
or w a, Exphes051
Revised 07/15/2014
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