HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR;APPLICATION TO BE ACCEPTED
.Date: Permit Number: CW
RECeIVED
Building Permit Application MAR -3 2016
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:
Address: cuq,-,
Legal Description: ftaj,� 0 6 il 4 Ar�� S 1��C_r-bf7( ,f T6 4 &tot—
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Property Tax ID#: 7D C)y Lot No.
Site Plan Name: Ltd i Block No. L
Project Name: CA- )
Setbacks Front Back: Right Side. Left Side:
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Additional work to be perrormed underthispelmil TalI t h Wat appy:
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Mechanical Gas Tank Gas Piping T ShuttersV V Windows/Doors
Electric Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 72-a Utilities: —Sewer _Septic Building Height:
Name
Name Name: e I-
Address:_ < o -L It)a.,, Company: Lei we r� C
City:---- . -t�* . P-,&Y- Ttajte. Address: PC) &)� -7 g 1 9 6� b
Zip Code: Fax: City: k,zp o state:
Phone No. 'l-7 Zip Code: 110 -7 li" Fax:
E-Mail: Phone No. 4U 7-
Fill in fee simple Title Holder on next page if di#erent E-Mail:
from the Owner listed above) State or Cmetwrty License: eA c yo Wqi'7
Z-zAkrl
If value of construToc is 2500 orore a RtCOR PED!Notice a Cam encementis equired
444
I
SUPPLEMENTAL CONSTRUCTION 7LAW INFORMATION:
DESIGNER ENGINEER. ^ Not Applicable MORTGAGE COMPANY: Not Applicable
Name: II 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 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 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 respect perform the work
in accordance with the approved plans, the Florida building Codes and St. Lucie County Amendmr t .
The following building perm' plications are exempt from undergoing a full concurrency revie r m additions,
accessory structures,swi Jur
pools, fen es,walls;signs,screen roorns and accessory uses t ar7o er non-residential use
WARNING TO OWN R: fai ret Record a Notice of Commencement may r suit' your paying twice for
improvements to OW/
ur pr per . A N tice of Commencement must be rec r,ed a d past n the jobsite
before the first ins ectior . I you int nd to pbtain financing, consult with I der o an a orn y before
commencingwor or rec ding you Notice of Commencement.
Signature of Qwn /Agent/Lessee Signature of Contr .tor/License Holder
i
STATE OF FLJANGE
DA i STATE OF FLO DA
COUNTY OF ij'� COUNTY OF off ,GE
I
Thr ,fo going i strum was ac owledge forelme The Torg ing ins u t was knowledge ore me
th;s' day f 2php this day o 20 by
F
PETER ACAFARI5 111 I 1 PF:TER A C AFARU III
(Name of person acknowl (Name of person acknow ie ing j
A_3%
( ignature f Notary Public-State of F orida }
JT1_inature o Notary Public State f Flor da )
Personally Known x OR Produced identification Personally Known x OR Produced Identification
Type of Identification Produced Type of identification Produced
I rp���
Commission No. EE 174164 '+ 1 mmission No. EE 174164 T P{, F1olk�r e-anhc State of Fton03
Nptary PuuiC state of Fiotid❑ x
Keri M Ricc�boni tCari M Riccaboni {,
y c My Commission EE 174164
of rte Lxpi,es 051'2812016
Revised{17115/2t)I.� x otfto Cxpleso5rze12016 ,
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW F EVIEW REVIEW REVIEW REVIEW REVIEW
DATE _ w
COMPLETE
INITIALS
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