HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Plate: (A' �• �J Permit Number: �-
.�rY� RECEIVED `
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Building Permit Application JUN 2 6 2015
Planning and Development services
Building and Code Regulation Division. `
2300 Virginia Avenue,Fort Pierce FL 34982 I,
Phone:(772)462-1553 Fax:(772)462-2578 Commercial Residential ;
i PERMIT APPLICATION FOR: To Select from dropbox, click here
PItOPO'EDEINPRflVEMENT LOCATION;
Address: C 2- 8 6 "-),Zj ty-- '7-1F-.et_A chr �
Legal Description: I..&GL �uc I�S�oas �Ia 4 -0 "'r
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Property Tax ID -70 3 - C)OZ1 C3 Lot No.
Site Plan Nance: Block No.
Project Name: Q&b No&-,r I'S-z
Setbacks Front Back: Right Side: Left Side: l
t-DETQitLfD��ESCRtf�Tt03�OFWORK °- - :�
co�usTlc'lo)�tj[�Ia �Ma-rlQt� t
Additional work to be De rme un er this permit-check all that appy:HVAC Gas Gas Tank []Gas Piping Shutters Windows/Doors L
Electric Q Plumbing nSprinklers U Generator E-]Roof 1
Total Sal.Ft of Construction: _ 5 -Ft-of First Floor: l
Cost of Construction:$ Z3 4 � utilities: _sewer septic Building Height:
11UNE ESSEE _ CONTRACTf�R
Name r I't' SSI�� ! Name; Peter Cafarc!Il t;
Address: (0 Company. Lowes Home Centers Inc. ;
City: a✓,4- s -f, r 4- 5tate:FL ; Address: P.O.Box 781993 i
Zip Code: Flax: City: Orlando State:FL i
Phone No. �T. = S Zip Code: 32878 Fax:561-771-0949
E-Mail: f Phone No. 772-418-3695
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! Fill in fee simple Title Holder on next page(if different E-Mail:TPG_Lpermits@yahoo.com
from the Owner listed above) i State or County License: CGC1508417 SLC#22986 �f
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If value of.construction is$2500 or more,a RECORDED Notice of Commencement is required ��
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNERf ENGINEER: Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: ! Address:
City: 1 State: City: State:
Zip: i Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: i Name:
Address: I I Address:
,
City: City: —
Zip: i 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 Countyl makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is irr 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,perrnit, 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:roorn 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 o '`.orney before
commencingiwor _r• recordi Notice of Commencement.
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Signature of •'nl?X, Signature o Contra ' r/l' nse Hol
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STATE OF FLORIJ s esti Les e STATE OF FLORI A
COUNTY OF -c _ COUNTY OFJLC
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The forgoing in;tnrm rt was acknowled edbfore me The forg Ing instru errL_-�+v.as acI vi,ledged b ore me
thi: jay of 20 by this ay of �+N��20 by
(Name o/f p acknoti ' ging) (Nam:eo:fpersona Fn gtn�
(Signature of Notary Public-State of Florida) (Signature of Votary PublicState of Florida )
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Personally Kno"I"X OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced_ Type of Identific tion Produced
Commission NO.. r-i• (Sef)1 CN BOC[i0h COmml$slon NO. `( B0c0r"W
1 A,,
Notary Puhltr -State of Flanda I 1•�r' NNary Public stale er Florida
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r'�C�'1S�d 0-1/i_`.��� '� '' cc�0ed .ou2't\2LonaI notary Assn Bonded Tttroudr;r,,,.,�n Nolary ASsn-
REVIEWS FRONT ` ZONING SUPERVISOR PLANS VEGETATION r SEA TURTLE ItitANGROVE
—;� COUNTER -� REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW —i
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