HomeMy WebLinkAboutBuilding Permit Application t—
ALL APPLICABL INFO NI ST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: CPermit Number: _y
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 click b
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Address:______ O� Uk Z�^� ✓ _ / —
Legal Description: LIrltt�s A-' 'S,a�/g�'1_rfq �•e A-211k-3b L.�'ir 1-7
Property Tax ID#: �,S r-70Z'/+ 0 l C V 000" Lot No. 1-7
Site Plan Name: Wh&6 .4 Block No. 3�0
Project Name:
Setbacks Front Back: Right Side: Left Side:
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�ttiona war to e e�fo�med`uri�er this permit"-check apply '
UHVAC Gas Tank Gas Piping �tters n Windows/Doors
aElectric F�Plumbing Sprinklers Q Generator a Roof
Total Sq.Ft of Construction: 5 Ft.of First Floor: i
Cost of Construction:$ ( , u Z� utilities: OSeptic Building height:
QW'NRf LESSEE; S a t a i CQITRACTQR r h :s.r t y£ sR
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Name N f�9Al.. Name: Peter Cafaro Ili
Address: '30(o9 FP �L/r rcv �'� Company: Lowe's Home Centers Inc.
City: Av,4-'S�L k, �9: State: Address: P.O. Box 781993 ! r
Zip Code- 3�RSrZ _ Fax: City: Orlando State:FL
Phone No. 17L- b7 3 /981 Zip Code: 32878 Fax: 561-771-0049
E-Mail: i Phone No. 772-418-3695
Fill in fee simple Title Holder on next page(if different E-Mail: TPG_Lpermits@yahoo.cam
from the Owner listed above) State or County License: CGC1508417 5LC#22986
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAMAN
FORiVIATION
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: AkNot Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLEHOLDER: 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. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full egncurrency review:room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses tb 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 Tender or orney before
commencing wor recordi Notice of Commencement.
Signature of / ent/Les a Signature o Contra r/ ' rise 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 fQ� oing instru nt w s acknowledge b ore me
this ' day of =�+ 20LL by thislWay of -r 20[ by
Peter Cafaro III Peter Cafaro III
(Name of p ackno ging)
(Name of person ac
(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
(yel6(I}TCH 6000OK ommission No. ,;` _ BOCOOK
Commission No. f,
Notar Public•S
tate of Florida =�_°• •�: Notary Public-State of Florida
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My Comm.EX13iFe" -
�'�� Commission #EE 176869 � P�° Commission tt EE 176869
Revised 07/15/20 1,CUM
°� ;A,, Bonded Through National Notary Assn. �,Eoe•����
��!�� Bonded Through N,Ilona)Notary Assn.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED _T