HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5 a1 >5 Permit!Number:
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MAY 2.12015 i
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Building Permit Application
Planning and Development Services I
Building and Code Regulation Division t
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2300 Virginia Avenue,Fora Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential 1
PERMIT APPLICATION FOR: To Select from dropbox, click here v- liA eerr.e w'7 ;
�fR31'a5EE3I-IPROUENlENT LC3CA2#C?l�l.
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Address: ( Z 'S'Z( 5 �No i �:��� �✓ _
Legal Description:
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Property Tax ID f#: "l�yH cCsy • nE– ( L ' O O ci- J4 Lot No.
Site Plan Name: Block No.
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Project Name: ���� 1J 2m}J.,,IS 14-e
Setbacks Front Back: Right Side: _ Left Side: l;
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ll"AILEQ'II� }2tFT#4 OF VIIC?RK.
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sttonaiworKtoDeDertormed under this permit--check all that appy.
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CHVAC Gas Tank Gas Piping _Shutters / Windows/Doors I
Electric ElPlumbing Sprinkler Q Generator 0 Roof i
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Total Sq.Ft of Construction: S . Ft.of First Floor: }I
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Cost of Construction:$ Z ' utilities: —Sewer 1_J Septic Building Height: ti
CONTICT-flR
Name a fie"b o`^�SSE rName: Peter Cafarc 111 1
Address:-12$21 S X^""n^ f-14— Company: Lowe's Home Centers Inc.
FL P.O. Box 781993
City: '�e,�eer. �rea c h State._. Address. _
Zip Code: 3�9�7 Fax: City: Orlando State:FL ;
Phone No. '_)-7 - Z7 �05Ky ' Zip Code: 32878 Fax: 561-771-0049 l
E-Mail: Phone No. 772-418-3695
Fill in fee simple Title Holder on next page(if different ` E Mail: TPG--Lpermits@yahoo.com l
from the Owner listed above) State or County License: CGC1508417 SLC#22986 I
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. !;
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SUPPLEMENTAL CONSTRUCTION LIEN IEN LAUU IN,F0RNIATI0N
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:
OWNER/CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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 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
commencing wort recordi Notice of Commencement.
SignatureIkillef/ ent/Les e- Signature o ntra r/ rise Hol
SPATE 0 FLORI STATE F FLFORI A
COUNTY OF SLC COUNTY Osic
The forgoing instrument was acknowled ed beforg me The for ing instrument was acknowledged before me
this� ay of /1 20 y this y of 1 � 20Qrby
Peter Cataro III Peter Cataro In
(Name of p ackno ging) (Name of person ack�tiagy)
(Signature of Notary Public-Sta a 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. (SepIftCH BOCOOK Commission No. ,T �;�,r BOCOOK
Notary Public-State of Florida
<,�;�: Notary Public -State of Florida
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9EXORS M2F F. 9XP!Fes Mat F,2016
- %+ �P:` COMMISSlpn et EE 176669
e �p°= Commission #EE 176869 •,'eoF��o?.-
Revised 0%/15/20 ��� Bonded Throuoh Nelional Notary Assn. Bonded Through N-i,onal Notary Assn.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
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COMPLETED