HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
s
'..._.. -- ....._.._...
meow 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 arrow at the end of line
v �. ,ya„ r r r�.z
Qll
Ffr .aA `4...,.....L
Address: Z k 8
Legal Description: %,A C.,.41:�o ncc I ( ?ate (
Property Tax ID#: 1d{502-^ 50 I - C-)Ll 3N- 0(:)O 'z Lot No.
Site Plan Name: l'-prVCri N� N; Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
mum
Ad�
Mona-I or to e e orme un ert ispermit=checka appy:
❑HVAC M Gas Tank Gas Piping _Shutters Q Windows/Doors
11 Electric ❑Plumbing Sprinklers ❑Generator ❑Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ 11100 ea..�Q Utilities:n_Sewer E]Septic Building Height:
Name "ry"O'.ag M ?Cel Name: Peter A Cafaro III
Address: Z 48 Ner- es $h/eP Company: Lowe's Home Centers, LLC
City: 7S9r:s . . State:_ Address: P•O. Box 781993
Zip Code: 3Al qS"7 Fax: City: Orladno State:FL
Phone No. Zip Code: 32878-1993 Fax:
E-Mail: Phone No.
Fill in fee simple Title Holder on next page(if different E-Mail: PRDn;'(-m;4*-Q_
�1olw�r�• ��+
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-LI•EN LAW INFORMATION
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: ANotApplicable
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.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 inspe ' yo intend to obtain financing, consult with lender or orney before
commencingwon recordi Notice of Commencement.
Signature of / ent/Les a Signature o Contra r/ ' rise Hol
STATE OF FLORI STATE OF FL RI A
COUNTY OF sI-c COUNTY OF sic
ThefAr� ng instrument was acknowled eg d before me The f oing instrument was acknowledg ore me
this, oiay of 110e-y"a✓ 20[_trby this ay of 20 by
Peter Cafaro III Peter Cafaro III
(Name of packno ging) - (Name of person ac to
(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
Commission No.
•"""" (SetW�CH BOCOOK ommission No. ""„ BOCOOK
n o.
Notary Public-State of Flofida �_0• .�: Notary Public -State of Florida
• • •
• Commiss on EE 176869
Commission#EE 176869 .;jF „a.'
OF F\, 111111111�1`
Revised 07/15/20 Bonded Through National Notary Assn. Bonded Through Ir,;tonaf NofaryAssn.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED