HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED _ (�
Date: Permit Number:
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 1�
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Address: 11 O L _P la rC'S L N
Legal Description: ��ervmT VA^fix x L--,7? 3
Property Tax ID#: ��33 ^�y 1 C�U�3 C�c'�� J� Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
'Ito a
1,1152 0;1
Add
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itiona I work tob ertormed under tis permit check all
, appy:
HVAC Gas Tank ❑Gas Piping _Shutters a Windows/Doors
aElectric F]Plumbing Sprinklers E]Generator F] Roof
Total Sq. Ft of Construction: — SFt. of First Floor:
Cost of Construction:$ 31 If 8 '- Utilities:n Sewer Septic Building Height:
-,.:r _ -.- -;,mac:-.. - ..sem'-. _ _-w-�.'Y'.'rSS'3 ^5 ,r.
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Name 's I t�E^r Name: Peter Cafaro Ill
Address: L(O 1'1 ��^rr5 LN Company: Lowe's Home Centers, LLC
City: State:�L Address: P.O. Box 781993
Zip Code: 3K9 ri�Z- Fax: City: Orladno State:FL
Phone No. 172^ � 3. .?� 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 CONSTRUCTION-LEEN LAW 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: 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 Countyy 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
commencing wor recordi Notice of Commencement.
Signature of / ent/Les a Signature o Contra r/ ' nse Hol
STATE OF FLORI STATE OF FLORI A
COUNTY OF_SLG COUNTY OF SLC
The foreoing instrument was gcknowled ed beforet me The forsoing instrument wils acknowledge before me
this'eVay of (�Crt—' 20LLby thisZn&Ltlay of �C'ir' 2 o-10 by
Peter Cafaro III Peter Cafaro III
(Name of p ackno ging) (Name of person ac w
(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
"����r ( MhCH BOCOOK
Commission No. ,. .n��•,, Se ommtssion No. BOCOOK
.`�: Notary Public-State of Florida °�• .�= Notary Public•State of Florida
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'= F �P°O Commission#EE 176869 �% „eP•'� Commission # EE 176869
Revised 07/15/20 Bonded Through National Notary Assn. Bonded Through N.;�onai Notary Assn.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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DATE
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