HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5 q Permit Number:
fl RECEII._D MAY 2 8 2015
Building Application
Permit A lication
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:
� haw son
Address: NJeo c t"CG% +e-cj
Legal Description: gv t t VC 5 S p hco-e T — b T 3
Property Tax ID#: 147, Lot No. 3 3
Site Plan Name: ,z£ r( j Block No.
Project Name: j QV'A'C
Setbacks Front Back: light Side: Left Side:
e e s
Additional be pertormed un er t is pe mit—check
a t at app y:
_Mechanical _Gas Tank _ as Piping _Shutters _Windows/Doors
Electric _ Plumbing _Sprinklers _Generator Roof
Total Sq. Ft of Construction:_ Sq. Ft. of First Floor:
Cost of Construction: $ �� Utilities: —Sewer —Septic Building Height:
Name Cl<0 Name:7 L6VJ C C,
Address: 11 (>vkeo I (A e S C;,ilCli Company:
City:��'l—_ , (�� Stagy e•' Address:
Zip Code: 3 491- t Fax: City: Stater
Phone No. Z" S0 Zip Code: a> Fax:
E-Mail: Phone No. *o_ R2,2
Fill in fee simple Title Holder on next page (if different E-Mail:
from the Owner listed above) I State or County License: 9.1 ��-f 17
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
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i
SUPPLEMENTAL CONSTRUMb'N' L(EN LAW INFORMATION:
DESIGNER ENGINEER: Not Ap licable MORTGAGE COMPANY: Not Applicable
Name: Name: T
Address: Address: _
City: Sate: 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: Zip: Phone:
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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 nting a permit will authorize the permit holder to build the Object 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 respect perform the work
in accordance with the approved plans,the Florida uilding Codes and St.Lucie County Amend t .
The following building perm plications are exen pt from undergoing a full concurrency revie :r m additions,
accessory structures,swi inJur
pools,fen es,walls signs,screen rooms and accessory uses t ano er non-residential use
WARNING TO OWN R: Y 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 btain financing, consult with I der o an a orn y before
commencingwor or rec din ou Notic o€Commencement.
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Signature of Own /Agent/Lessee Signature of CInfor/License Holder
STATE OF FL IDA STATE OF FLACOUNTY OF ANCE COUNTY OFEThe oing i strum r was acknowledge efore me The%ng ine t as acknowledg d�by
ore me
this Z�day
-IAN
20 . by this ay o 20
PETER A CAFAR'b III 1 PETER A CAFARO III
(Name of person acknowl (Name of person acknowle ing
( ignature f Notary Public-State of F arida} (Si nature 01
Notary Public-State bf Florida }
Personally Known x OR Produced tdentifica'in Personally Known x- OR Produced Identification
Type of identification Produced Type of Identification Produced
Commission No. EE 174164 mmission N0. EE 17a1&4 P, .is+AI,cStateof Florida
Y P(, Notary Put
e of Flofida °�,.
"-A Kari M Rni Kari M RiCcaboni {'
• ".1 14, "` My Commission EE 174 164
TAY kUFT1I111%,b1ff at 11411). ei n° Lxpi,es 05r26t2010
Revised 07/15/2014 } of, t-:xpires 05126(2016
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