HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: S 5 Permit Number:
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• RECEIVED JUN 15 1015
Building Permit Application
Planning and Development Services
Building and Code Regulation Division,
2300 Virginia Avenue,Fort Pierce FL 3982 ✓�f� I
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
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PERMIT APPLICATION FOR:
To Select from dropbox, click here —S
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Address: '0_L4 00 (L4 Vey Avvi d ac.le—
Legal Description: e-oJ¢-, ITA+'Kma ,,_ LoT
Property Tax ID#: J - 1 D - O�y� . ��V' Z Lot No.
Site Plan Name: ���' (I Block No.
Project Name: s'
Setbacks Front Sack: Right Side: Left Side: �
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Additional won to DeMi-tormed under this permit—checK all Imapply:
F]HVAC LJ Gas Tank F]Gas Piping _Shutters a Windows/Doors
aElectric Plumbing Sprinklers Generator Roof (f
Total Sq.Ft of Construction: S . Ft.of First Floor:
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Cost of Construction:$ ro8� Utilities: _Sewer Septic Building Height: ;
£ N€RETE f CUNTl:2Air�TDR
Name aso t4A I Name: Peter Cafaro Ill
1[ u — Lowe's Home Centers Inc.
Address: y0 1�-i��✓ Ar►+ oc�l•v, Company: _
City: �r f���+� _ State:FL Address: P.O. Box 781993
Zip Code: 3q9,6 Fax: City: Orlando State:FL '
Phone No. -77Z,- -/(0- Zip Code: 32878 Fax: 561-771-0049 i
E-Mail: Phone No. 772-418-3695 I
TPG_Lpermits ahoo.com
Fill in fee simple Title Holder on next page(if different E-Mail: —Lpermits@yahoo.com
from the Owner listed above) State or County License: CGC1508417 SLC#22386
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. _
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SUPPLEMENTAL CONSTRUCTION'CLEN LAW INFORMATION
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
commencingwor4 recordi Notice of Commencement.
Signature of / ent/Les a Signature o Contra r/ ' nse Hol
STATE OF FLORI STATE OF FLORI A
COUNTY OF_SLC COUNTY OF SLC
The forgoing instrument was acknowledged beforet me The forgoing instrument was acknowledged before me
this_day of 20L_J by this_day of .200 by
Peter Cafaro III Peter Cafaro III
(Name of p ackno ging) {Name of person ac tta
i
(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. ""�, (SeN{hCH BOCOOK Commission No. """ . BOCOQK
Notary Public-State of Florida �'�= Notary Public-State of Florida
- .
Commission #EE 176869 ";;�F����c���� Commission a EE 176869
Revised 07/15/20 ° "� Bonded ihrou0h National Notary Assn. ""
Bonded Through Nouonal Notary Assn.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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