HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FO APPLICATION TO BE ACCEPTED
Date: l Permit Number:
JUN 2 5 2015:,,uildin,g Permit Application
Planning and Development Services
Building • ► Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
• • • • i Commercial
PERMIT APPLICATION FOR:
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Legal Description:
PropertyD •:
BlockLot No.
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Site Plan Name:
Project Name: e-
Setbacks Front Back: • Side:
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r r this pe mit--check alTthat apply:
Piping
—Mechanical GasTank —Zaas
Electric Plumbing SprinklersGeneratorRoof
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of • i E7 ♦ _Septicr
ing Height:
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Name—
Address:—
B i i i
Y
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Phone No. • •r` ►
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simpleFill in fee
• • on
from the Owner listed above) afft
If value iconstruction • i • ` r iNoticeof Commencementrequired.
I
SIJPPI_EMENTAL CONSTRUCTION` IEN LAW INFORMATION:
DESIGNER/ENGINEER:' ^ Not Ap I IIIicable MORTGAGE COMPANY: Not Applicable
Name: _ Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Ar) licable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City: _
Zip: Phone: _ _ _ Zip: Phone:
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 sociation and review your deed for any restrictions which may apply.
In consideration of the granting of this requested p rmit, I do hereby agree that I will,in all respects perform the work
in accordance with the approved plans,the Florida u0ding Codes and St.Lucie County Amendm t .
The following building perm' plications are exe pt from undergoing a full concurrency revie :r m additions,
accessory structures,swi in pools, fI
,walls signs,screen rooms and accessory uses t ano er non-residential use
WARNING TO OWN R: Y ur fall Reco d a Notice of Commencement may r suit' your paying twice for
improvements toy ur pr per . tice f Commencement must be ret r-ed a d post n the jobsite
before the first ins echo . I you nd to lObtain financing, consult with I der o ana orn y before
commencin wor or rec din Notic I of Commencement.
Signature of Own /Agent/Lessee Signature of Conti for/License Holder
STATE OF FL IDA STATE OF FIL DA
COUNTY OF 3NCE COUNTY OFUu rcE
The forgoing i strument was acknowledged before e The forgoing ins ument was acknowledged ore me
this—day f 20.14. by, this day o 20 1,1 by
PETER A CAFAR$III PETER A CAFARO III ''u•
(Name of person acknowl (Name of person acknowle ing j
( ignature f Notary Public-State of F orida} (Si nature o Notary Public State f Flor da }
Personally Known x OR Produced Identification Personally Known x 'OR Produced Identification
Type of Identification Produced_ Type of Identification Produced
Commission No. EE 174164 mmission No. EE 174164 0
Y v Notary Public State or Florida x ° N°thT rl'c State of Florida {
AP u �� Kari M RiCCaboni 1
Kari M Ricc boni c o My Commission EE 174164
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