HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INF�M��E COMPLETED FOR APPLICATION TO BE ACCEPTED G� 05-50Date: 3 Permit Number: 5
I
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 D�
PERMITAPPLICATION FOR:
Address: GI� LAAf e I &A V Y
n
Legal Description: ci o " o Z7 --®vc7 �� Lai�'e.vDaUN1� �U(b f�jj"
Property Tax ID#: .6 Lot No. c�Q
Site Plan Name: Block No. /
Project Name: C 6 ,
Setbacks Front Back: ight Side: Left Side:
n �
oe,
BEIM
i ional worK to be performed under this permit-check all that appy:
_Mechanical _Gas Tank —blas Piping _Shutters _Windows/Doors
_Electric _Plumbing _ISprinklers _Generator _ Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $�O Utilities: —Sewer _Septic Building Height:
Name d Name: • U
Address: 7 6 SCG Company:LQ UU 1
City: e l�C.Q Sta - Address: / -79 114c-i 3
Zip Code: �j g '�( Fax:I City: 1 State:
�Phone No. p
E-Mail: Phone No. 7 _ 3 70` 7
Fill in fee simple Title Holder on next page ( if di erent E-Mail: '32--(-
from the Owner listed above) State or County License: CA C- I S-Oa X03
j 2,Zg co
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION"IIEN LAW 1NFORMATION.
DESIGNER/ENGINEER: Not Apt Jlicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: _ State:
Zip: Phone: _ Zip: Phone:
FEE SIMPLE TITLE HOLDER: —Not Ap licable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City: _
Zip: Phone: I Zip: Phone:
I
i
I certify that no work or installation has commence' prior to the issuance of a permit.
St.Lucie County makes no representation that is gr sting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owne s Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult with your Home Owners sociation 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 Amendm t .
The following building perm' plications are exempt from undergoing a full concurrency revie :r m additions,
accessory structures,swi in pools,fen es,walls signs,screen rooms and accessory uses t ono er non-residential use
WARNING TO OWN R:Y ur fai ret Reco d a Notice of Commencement may r suit' your paying twice for
improvements to y ur pr per . A N tice f Commencement must be rec r ed a d post n the jobsite
before the first ins ectio . I you int nd to blain financing, consult with f der o an a am y before
commencin wor or rec din ou Notic of Commencement.
I
Signature of Own J Agent/Lessee Signature of Contr for/License Holder
STATE OF FL IDA STATE OF FLO DA
COUNTY OF ANGE COUNTY OF OR 1GE
The fort`k ing i strume t was ac wledgetir ore me The forgoing ins ument was aCkn wledged ore me
this day f Y 20 flf'i by i this day a V 20 y
PETER A CAFARb III 1 PETER A CAFARU III
(Name of person acknowledg' (Name of person acknowle Ing}
11 r
( ignature f Notary Public-State of Florida} i (Si nature o Notary Public-State f Flor da }
Personally Known x OR Produced IdentificatilpIT Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
EE 174164 mmission No. EE 174164 yPl ((
COmmi551an NO. y nU � Not6rtrc State or Florida {
Notary Public Slate of Florida ; Kari M Riccaboni
Kari M Rico boni y,c, < to Commission E 174 164
Jet:. IAy} of poe Expires 0512 2016 � of}oma r lxnires 05R6t20t6
Revised 07/15/20 14
I
REVIEWS FRONT ZONINGSU ERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW EVIEW REVIEW REVIEW. REVIEW REVIEW
DATE
COMPLETE
INITIALS