HomeMy WebLinkAboutBuilding Permit Application ALL APPLICA E INF MUF 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
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
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Address: to
Legal Description:
Property Tax lD#: ��J ( ( � 'Sol Lot No. I
Site Plan Name: �.h r� s���u �A,not Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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Additionalwork to be nertormed under this permit=check all t=appy:
HVAC Gas Tank F]Gas Piping _Shutters ❑Windows/Doors
FlElectric ❑Plumbing Sprinklers 1:1 Generator ❑ Roof
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction:$ 1 25K Utilities: Sewer O Septic Building Height:
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PRO
Name
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Name ✓i5"4o ht V—A-A"% 5 Name: Peter Cafaro III
Address: 101 :LrJ Company: Lowe's Home Centers, LLC
City: State: - Address: P.O. Box 781993
Zip Code: 'Fax: City: Orladno State:FL
Phone No. 3 CvLlif,a 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 LIEN Li4W INFORMATION
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: AKNot Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: of Applicable BONDING COMPANY: Not Applicable
Name: 4=1Name:
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 thepermit 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
commencingwort recordi Notice of Commencement.
Signature of / ent/Les a Signature oQo=ntrar>'�_�nse Hol
STATE OF FLORI STATE OF
COUNTY OF sic COUNTY OF st.0
The forgoing instru ; as gcknowled eg d_before�me The farsoing instru ntOwils acknowledge��fore me
this day of 1"W 20®�by this l�`lday of 1� V ,20EM-by
Peter Cafaro 111 Peter CafaroIII
(Name ofp ackno ging) (Name of person ac ewt2'd wg7)
(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. (Se&{I)TCH BOCOOK ommission No. BOCOOK
Notary Public-State of Florida .'^: Notary Public-State of Florida
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20
+.F ��?;= Commission#EE 176869 ';�e °•'� Comm�ssron # EE 176869
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Revised 07/15/20 Bonded Through National Notary Assn. Bonded Through N�itonal of
Assn.
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