HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: `� I \5 Permit Number:
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5 M �'z RECEI�''D SEP 012015
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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 _
PERMIT APPLICATION FOR: To Select from dropbox, click here
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Address: �J�G12 W17 1� i
Legal Description: Gyo\ie_ C n 1n.�vw;r. cvvti '� u►+i� ��j
Property Tax ID#: -3Ltto -150-1 - 0172to o00 t z Lot No.
Site Plan Name: (y—UA Block No.
Project Name: j
Setbacks Front Back: Right Side:_ Left Side:
(.lSIC' ' 2.0
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Additional work to be nertormed under t ispermit-check all mal apply:
HVAC Gas Tank El6as Piping _Shutters "Windows/Doors
Electric Plumbing Sprinklers F1 Generator Roof
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Total Sq.Ft of Construction: Sq.Ft.of First Floor:
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Cost of Construction:$ 2(O Z Utilities: Sewer Septic Building Height: 4
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Name ;Sp^z% Name: Peter Cafaro III 4
Address: 6"772- most Cr- -78 Company: Lowe's Home Centers Inc.
City: 1;4.A- JPigA4,4 State:FL ; Address: P.D.Box 781993
Zip Code: 3L1982 Fax: 1 City: Orlando State:FL =
Phone No.''1 Z- 5-77-702-5 i Zip Code: 32878 Fax: 561-771-0049
E-Mail: Phone No. 772-418-3695
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 l
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
i
SUPPLEMENTAL CONSTRUCTION. LIEN tAW 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: Nat 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
commencingwort recordi Notice of Commencement.
Signature of / ent/Les e• Signature o Contra r/ '�nseftl
STATE OF FLORI STATE OF FLORI A
COUNTY OF SLC COUNTY OF SLC
The forgoing instrun nt was acknowledged before!me The forgoing instru ent was acknowledged g
e-d�b.e�fore me
this day of 20 by this' day of 201 ► oy
Peter Cafaro III Peter Cafaro III
(Name of p ackno ging) (Name of person aLn
ell
(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
•""""' (SeDfhCH BOCOOK Commission No. „"COOK Commission N0. "" BOCOOK
Commission No. MIP:Notary Public-State of Florida �2°• .'�: Notary Public•State of Florida
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, Commission#EE 176869 �''.�';F °��
�'4`�Or i�nP••
����`��, Commission # EE 176869
Revised 07/15!20 Bonded Throuoh National Notary Assn. ""��� Bonded ihrou h tv�tionat
9 Notary Assn.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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