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HomeMy WebLinkAboutBuilding Permit Application ALL APPLIC BLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 11` _ Permit Number: �� J 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 here j PRCIPOS�i�tl�PitQ1�EI�ENT I;OCATION, ,` _ _ `� =Y Address: Q V Legal Description: W,A ID g 1 T5 Property Tax ID#: 3 LA 0 3 Lot No. Z Site Plan Name: nn Block No. Lf Project Name: b e 00'--0 h Setbacks Front Back: Right Side: Left Side: 1 COItTIC}I�I; FtAT!©Nx Add : I ��_�„ ,�� •_..''• '•w..,.°. "�..a„r �r���"C€�z,3 .."a`��.t`�'„�r� itiona wor to e nerfoFmed�under tfiis ermit the t a apply: HVAC IJ Gas Tank Gas Piping ( _Shutters Windows/Doors 11 Electric ElPlumbing Sprinklers I I Generator Roof Total Sq.Ft of Construction: __ Sq. Ft.of First Floor: Cost of Construction:$ 3 9 Utilities: _Sewer O Septic Building Height: � k NamePs .~� h•onr��-. StA-J Q&.►v''___ ; Name: Peter Cafaro lf! Address: : Company: Lowe's Home Centers Inc. 3 City: fT r%,311e-rdfi State:FL Address: P.O. Box 781993 Zip Code: 3 4 q:9 Z Fax: City: Orlando State:FIL Phone No. 077-��e� ' d I u j Zip Code: 32878 Fax: 501-771-0049 _ E-Mail: Phone No. 772-418-3595 Fill in fee simple Title Holder on next page(if different E-Mail: TPGLpermits@yahoo.com from the Owner listed above) State or County License: CGC1508417 SLC#22986 if value of construction is$2500 or more,a RECORDED Notice of Commencement is required. i :SUPPLEMENTAL CONSTRUCTION LEEN LAW INFORNMATIQN PRM AT-. _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: OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated. (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 may result in your paying twice for improvements to your propert . A Notice of Commencement must be recorded and posted on the jobsite before the first inspec ' yo intend to obtain financing, consult with lender or orney before commencingwor recordi Notice of Commencement. Signature of / Signature o Contra r/ ' rise Hol STATE OF FLORI ent/Les a STATE OF FLORI A COUNTY OF SLC COUNTY OF SLC The for�ggoing instrument was acknowledged before me The forgoing instrument was acknowledged before me thisd f'lday of /�f�c� 20�by this g�y of LLA& 20_(?by Peter Cafaro III Peter Cafaro III T (Name of p ackno ging) (Name of person ac wtgc�95 (Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida} Personally Known x OR Produced Identification Personally Known x OR Produced Identification Type of Identification Produced Type of Identification Produced Commission No. •"""' (SeMhCH BOCOOK Commission No. I—om_ BOC3Assn. ° =_°. .`�? Notary Public-Stat Notary Public-State of Florida �NPirDS Mair F.2016 Q. °' Commission #EE 176869 %�F °�°•' Co mmissron # EE Revised 07/15/20 Bonded Through National Notary Assn. " ""•�, Bonded Through Nauonal REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED