HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FORIAPPLICATION TO BE ACCEPTED J/
Date: ��`� �� ' Permit Number:
i
RECEIVE
OCT 2 g 2015
y W Building Permit Application
ication
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: :7)�
i
Address:
Legal Description: �-
Property Tax ID#: �J°(� Lot No._.(�._
Site Plan Name: f iso Block No.
r
Project Name:
Setbacks Front Back: Right Side: Left Side:
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0 L U &
SWIMMER=
Additional work to be pertormed under this permit-chprk checka t at appy:
_Mechanical — 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: $ �(��� Utilities: —Sewer T Septic Building Height:
Name to S 4 V' !X C Name: lr Cam CLA-0
Address: 0 a Company: W ' S ��
City: �e,4r State: Address: n d 8 !
Zip Code: � .9 Fax:__ < b City: r CL� 0 State:]`�-
Phone No. -? -7 Z � � Zip Code: '; '2-e 7 p Fax: _T
E-Mail: P ane No.
" ,()7-
Fill in fee simple Title Holder on next page (if different ES� 1 w �,2-(-2, 3 `063
from the Owner listed above) State or Gett License: f7
7-2"
If value of construction is 2500 or more,a RECORDED.Notice of Commencement is i1equired.
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SUPPLEMENTAL CONSTRUCTION'LIEN 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: __ Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: 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 thepermit holder to build the subject structure
which is in conflict with any applicable Home Own efs Association rules,bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Vciabon 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 respect perform the work
in accordance with the approved plans,the Florida Building Codes and St. Lucie County Amendme, t .
The following building perm' plications are exempt from undergoing a full concurrency revie :r m additions,
accessory structures,swi in pools, fen es,walls; signs, screen rooms and accessory uses t an0 er non-residential use
WARNING TO OWN R: Y ur fai re t Record 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 post 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( ding you Notice of Commencement.
Signature of Own /Agent/Lessee ! Signature:of Conti -tor/License Holder
STATE OF FL IDA STATE OF FLO pA
COUNTY OF �r,ca COUNTY OFoN +��
The frog i strume t was awledge reline The flgoda ins um t�a� knowledge re me
this day flr� �, 20 _ hN thisJ—�f►day a , 20 by
1
PETER A CAFARO III 1 PE TER A CAFARO til
(Name of person acknowl (Name of person acknowle ing j
C, 7�
( ignature f Notary Public State of F1_orida J (Si nature o Notary Public-State f Flor da )
Personally Known x OR Produced Identificatiion Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
EE 174164 mmiSSiOn N0. EE 174164 �P t
Commission No. �e Noli.�fR t,c Slate of Flon^�{
Y pt, Notary Puki clState of frolic❑ ; Kari M Riccaboni {'
Kari M Riccf bont < My Commission EE 174164
of no @zpves 0 512 8120 1 6
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW E MEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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