HomeMy WebLinkAboutBuilding Permit Application ALL APPLI BLE INFOMUSTBE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Y. . /` Permit Number:
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RECEIVED-
Building Permit Application
Planning and Development Services SEP 2 2 2015
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 arrow at the end of line
ers
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Property Tax ID#:3L(LP' "563 , Q2Lot No. Z
Site Plan Name: Me,10+J8, 6 (d 1.0 IV Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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rtiona war to e e orme un er t is permit_
:heck all apply:
HVAC Gas Tank Gas Piping _Shutters ❑Windows/Doors
Electric ❑Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ :2z Utilities: _Sewer E]Septic Building Height:
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NameI�L�d Pi c _��o h! Name: Peter A Cafaro III
Address: -�Ac,u Y04i S N Company: Lowe's Home Centers, LLC
City: State: Address: P.O. Box 781993
Zip Code: 3�c1 Fax:,- City: Orladno State:FL
Phone-No.77Z.�.5? .. Oct Cdo Zip Code: 32878-1993 Fax:
E-Mail: Phone No.
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License: CGC1508417
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTfON LIEN LAW INF:ORIVIATION':
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: AkNot Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: of 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. LucieCounty 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 Commencep, ent 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 inspe - yo intend to obtain financing, consult with lender or orney before
commencing wor recordi Notice of Commencement.
Signature of / ent/Les e• Signature o Contra r/ nse Hol
STATE OF FLORI STATE OF FLORI A
COUNTY OF SLC COUNTY OF SLC
The or oing instrume t was cknowled ed before me The f oing instru . nt w s acknowledge b ore me
this `s day of 20M by this. ay of p 20 by
Peter Cafara III Peter Cafaro III
(Name�packno ging')� (Name of person ac 9
(Signature of Notary Public-Sta a of Florida) (Signature of otary Public-State of Florida)
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. ."";""-, (SeMhcH BOCOOK ommission No. "... EaF
e
2816
Notary Public-State of Florida . Notary Purida
• • _ - • •
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f:
r���� Commission #EE 176869 ";rF °•' Commis9Revised 07/15/20 Bonded Through National Notary Assn. Bonded Throussn.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
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