HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR;APPLICATION TO BE ACCEPTED
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Date: %�..: � Permit Number: 5�07"0l
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RECEIVED
Building Permit Application AUG 13 2015
Planning and Development Services
Building and Code Regulation Division
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2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR`.
Address:-- - olEe-vt S fX
Legal Description: L jf q, i � G 9 +�.,�( 1;<'
Property Tax 1D#: )4 Z3 661- Ocip QOc) -'U Lot No.
Site Plan Name: Block No. `l'
Project Name:_ f�L6(,V
Setbacks Front_ Back: Right Side: Left Side:
------------- --- Now
Elm
P L-&a-e,7 eq/ "Iz6l ad
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Aclaitional work to be pertorme 7n'Mer this ped mit-check aill t at app y:
_Mechanical _Gas Tank Gas Piping Shutters Windows/Doors
Electric — Plumbing Sprinklers i Generator _Roof
Total Sq. Ft of Construction: _ Sq. Ft. of First Floor:
Cost of Construction:$ I I AF Utilities: —Sewer —Septic Building Height:
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Name �i Gt)�/t S Name:` tle 1� ?r, CLA-0
Address: C m Company: tO we r e e+S 1.L
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City: ( �.L•�" State: � Address: "7 c� I 9 -!1 '--�
Zip Code: 5 g cILIC Fax: (� City: KI CL-i State j-
Phone No. Zip Code: 2 "Le 7 li" Fax:
E-Mail: Plaone No, 40 7- �3
Fill in fee simple Title Holder on next page (if different E- ' S-C W 32 I U3 -U(4 1/
from the Owner listed above) State or 6e wrty License: C. O S b W q 17
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If value of construction is 2500 or more,a RECORDED'Notice of Commencement is equired.
SUPPLEMENTAL CONSTRUCTION"LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address: _
City: State: City: _ _ State:
Zip: µ Phone: -- _---. Zip: _ Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable 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 Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested pgrmit, I do hereby agree that I will,in all respect perform the work
in accordance with the approved plans,the Florida Building Codes and St.Lucie County Amendm t .
The following building perm plications are exempt from undergoing a full concurrency revle}}^^' r m additions,
accessory structures,swi lin pools, fen es,walls;signs,screen rooms and accessory uses tq ar7o er non-residential use
WARNING TO OWN R:Y ur fat ret Record a Notice of Commencement may result your paying twice for.
improvements to y ur pr per . A N Lice of Commencement must be rec r ed a d post n the * bsite
before the first ins ectio , i you int nd to obtain financing, consult with 1,1..4 er o an a orn y before
commencin war or rec djng�you Notice of Commencement.
Signature of Own i Agent/Lessee Signature of Conti .tor/License Holder
STATE OF FL IDA STATE OF FIL DA
COUNTY OF NGE � COUNTY OF oN ,cE
The for oin i suumen w t ac.nowI d ed b- ore:me The forf��`jling in u nt was acknowledged re me
this day f 20 .�_...- h� this t day o 20 by
PETER A CAFARt 111 PEJER A(,AFARU III
(Name of person acknowlPg (Name of person acknowle ing 1
,
( ignature f Notary Public-State of F arida 1 (Si nature o Notary Public-State f Flor da 1
Personally Known_xOR Produced Identification i Personally Known x OR Produced Identification
Type of Identification Produced-----_—._--_ __ ' Type of Identification Produced
Commission No. E6 174164 a mmission No. EE f74t&4 YPv Not�ryr'lRlk Stare of Flonda {
Y PIS Notary PubliCIState of Florida ? Kari M Riccaboni 1
'4 ^, Kari M Ricc Boni
My Ccmmission EE 174 164
V.1":Fto— — xP iY 28/2�i6 �Expit ,es WM2016
Revised 07/15/20 14
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DATE ----�----- —_._ - ..._
COMPLETE
INITIALS