HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED d
Date. $11 �5 Permit Number: ° ^ a7;;�rO
T'— RECEIVED AUG 14 2015
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division ,
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential
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PERMIT APPLICATION FOR To Select from dropbox, click here
RRtPQSER iNPRVEtl: NT(OCATlN„ ': . -
Address: Zto t GVrV_
Legal Description: `�—we- W E- 0-A'-z-1 &-SA-;rt eS- Lir 13 I
Property Tax ID#: 3 ��' ��� L'h��3 �� - Lot No. 13
Site Plan Name: vs,^;E Block No. 1
Project Name: {
Setbacks Front Back: Right Side: Left Side:
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CO�1STFf��'GTtON IN�t�RMATION< .�
Additional worK to be e orm`m ed under this permit-check all mat apply:
HVAC 0 Gas Tank ❑Cas Piping Shutters gwindows/Doors !
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a Electric Plumbtng • Sprinklers 1:1 Generator O Roof
Total Sq.Ft of Construction: Sci.Ft.of First Floor: i
Cost of Construction:$ t9L9 R� Utilities: Sewer Septic Building Height: 771
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9W r r ( CQIYTRA41 4 as 3 m
Namewa,.. QE.fl Name. Peter Cafaro Ill w
Address: ?--(oI 1 C�re��C 4-+� L N ' Company: Lowe's Home Centers In(--
City: TT J)f&A-alL State:FL ; Address: P.O.Box 781993 i
Zip Code: 'J�IQc�jI Fax: i City: Orlando State:FL
l Phone No. _MZ-30 1 - 189, + Zip Code: 32878 Fax: 561-771-0049 I
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E-Mail: � Phone No. 772-418-3695 !
11 Fill in fee simple Title Holder on next page(if different E-Mail: TPG_Lpermits@yahoo.com '
from the Owner listed above) State or County License: CGC1508417 SLC#22986
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If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATLO:N
DESIGNER/ENGINEER: _ of 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.LucieCounty 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 property. 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
commencingwor! recordi Notice of Commencement.
Signature of / ent/Les a Signature o Contra r/ ' rise Hol
STATE OF FLORI STATE OF FLORI A
COUNTY OF sl C COUNTY OF st.0
The forgoing instrument was acknowled ed before me The forgoing instru ent was acknowledged before me
this � day of .sem 20�by this�l day of 2Q110 by
Peter Cafaro III Peter Cafaro III
(Name of p ackno ging} - (Name of person��a� ua
(Signature of Notary Public--Sta eo'f 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
•"""" (SeMhCH BOCOOK ommission No. �•",Y.�,� BOCOOK
Commission No. ,. ,.n•�, o`
0 .`�= Notary Public-State of Florida =��• .�= Notary Public-Slate of Florida
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=,;,F ��= Commission#EE 176869 F 0°�� Commission # EE 176:�
669
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Revised 07/15/20 Bonded Throuoh Nal M]Notary Assn. Bonded Through N.;tonal Notary Assn.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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