HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE NFO NUST BE�OMPLETED FORIAPPLICATION TO BE ACCEPTED
Date: CC�� Permit Number:
Puilding Permit Application
Planning and Development Services j
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: `v-\
Address: q VIA
I
�}
Legal Description: �c' R, 1< Vrzv a gL' l'
130 )-� ({ —o7�0 -I
Property Tax ID#: Lot No.
Site Plan Name: Block No. >l
Project Name:
I
Setbacks Front Back: Right Side: Left Side:
u
4
Mitionawor to e pe orme un er"Pe isWceck all tat app y:
—Mechanical Gas Tank _Gas Piping 4 Shutters )<Vindows/Doors
_ Electric Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 01 -) .10 Utilities: —Sewer `Septic Building Height:
I
ame F 1 Name: t� �a, cLirO ITT
dress: ' Company: w e r ,r?...L. C
City: eO L Stajte: Address:
Zip Code: Fax: City: ✓ Gl.k, 0 State:_a
Phone No. -7-7 2, —4(, L( — 62�� Zip Code: 2$7 Fax:
E-Mail: Phone No. 40 7— 9,S 2 ' a Oe
Fill in fee simple Title Holder on next page { if different V&k Mzd Z --0 3
from the Owner listed above) State or 6etttrtq License: C(4 S7 0
If value of construction is 2500 or more,a RECCIRDED':Notice of Commencement is equired.
1
i
SUPPLEMENTAL CONSTRUCTION'L'IEN LAW INFORMATION:
DESIGNER ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address: _
City: State: City: _ State: _
Zip: Phone: A Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not ApRiicable BONDING COMPANY: Not Applicable
Name: i Name:
Address: Address:
City: I City: _
Zip: Phone: Zip: Phone:
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 Owne s Association rules,bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners sociation and review your deed for any restrictions which may apply.
In consideration of the granting of this requested p rmit, I do hereby agree that I will,in all respect perform the work
in accordance with the approved pians,the Florida I uilding Codes and St. Lucie County Amendm t .
The following building perm' plications are exen7Pt from undergoing a full concurrency revie : r m additions,
accessory structures,swi Jur
pools, fen es,walls;signs,screen rooms and accessory uses t ano er non-residential use
WARNING TO OWN R: fai re t Recotjd a Notice of Commencement may r suit' your paying twice for
improvements to y ur pr per . A N tice Of Commencement must be rec r,ed a d past n the jobsite
before the first ins ectio , I you int nd to'obtain financing, consult with I der o an a orn y before
commencingwor or rec in ou Notice' of Commencement.
Signature of Own J Agent/Lessee I Signature of Contr for/License Holder
STATE OF FL IDA i STATE OF FLO DA
COUNTY OF ANGE i COUNTY OF off rGE
The f rgoing i strumen was nowledged b ore'me The fo going ins ument was acknowledge ore me
this day f � � 2Q this day o �✓ 20 by
i
I
1 PETER A CAFAR�111 i PETER A CAFARQ!II
(Name of person acknowl (Name of person acknowle ing)
L1 ,
ignature f Notary Public-State of F orida (Si nature o Notary Public- State f Flor daa
Personalty Known x OR Produced identificatibn Personally Known X OR Produced Identification
Type of Identification Produced Type of Identification Produced tt�Cpaa�t�1
Commission No. EE 174164 I mmission No. EE 174164 y pV� Notki9 "I-c Stale of Floncia <
�� Y pW. Notary Pu kc State of 171.6da ; Kari M Riccaboni <,
`F Kari M Ricc�boni c9 My Ccmmtsslon EE 174IG4
} of"'OeL'xpue405.26I2016 ' of noAzpies R6t20fo
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW fEVlEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS