HomeMy WebLinkAboutBuilding Permit Application Uz3TI
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Z (0 Permit Number:
RECEIVE®
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Building Permit Application MAR 2 4 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: To Select from dropbox, click arrow at the end of line
MIN__ ._.i:< ' 's?.,f.,,r''; ". �' '`j°';rf;+' ✓"xsi�ilFA'" .sem to
Address: '-1 l l f-Q 1a&
Legal Description: e►u c.. G%V- 0A "T I-,
Property Tax ID#: �J419`5V-0 -0- 1'4 5 - o%ticz . Lo Lot No. 17
Site Plan Name: C wr.I Block No. IN
Project Name:
Setbacks Front Back: Right Side: Left Side:
05005-1-1 ME,NERDIMII,� 5,
�SstrL� 3 ��,.,•r.nt Sw...�F1�.rs
_ 6 - v - - �p,..l {74
Additional work to e e orme un e=�thDi rMnW appy:
HVAC Gas Tank Gas Piping _Shutters Windows/Doors
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Electric El Plumbing Sprinklers 0 Generator F] Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ Z$Z(o Utilities:n Sewer E]Septic Building Height:
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Name �)AJto C-4 Name: Peter A Cafaro Ill
Address: L4-11 iA3 la,Nt7MhL• Company: Lowe's Home Centers, LLC
City: k State:FL Address: P.O. Box 781993
Zip Code: 34T5?_ Fax: City: Orladno State:FL
Phone No. (004 - -539 . 0.4'30 Zip Code: 32878-1993 Fax:
E-Mail: Phone No. 5(01 - 72 1 -:5(oll
Fill in fee simple Title Holder on next page(if different E-Mail: <b �►�k w•:�u. bib�rw:l. cam
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 LAW INFORMATION:
DESIGNER/ENGINEER: 7\Not Applicable MORTGAGE COMPANY° Not Applicable i
Name: ( Name:
Address: I! Address:
City: State: 1 City: State: '
Zip: Phone: Zip: Phone:Wit !
FEE SIMPLE TITLE HOLDER: of Applicable BONDING COMPANY: Not Applicable j
Name: Name: i
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I
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
commencing wor recordi Notice of Commencement.
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Signature of / ent/Les e Signature o Contra r/Lnse Hol
FLORI A
I
I
STATE OF FLORI STATE OF
COUNTY OF SLC COUNTY OF SLC {
I The foreoing instrument was 4cknowled ed before me i The fnrsoing instrument wets acknowledgerj p fore me
this��ay of VO4vc420 y this??%coday of Ket. 20 by
jPeter Cafaro III Peter Cararo 111 i
i (Name of peFso ackno ging) - � (Name of person ac E1n
(Signature of Notary Public-State of Florida) j (Signature of'Notary Public-State of Florida) ^� 1
Personally Known x OR Produced Identification I Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
i
i
Commission No. "";''., (SeMhCH BOCOOK Commission No.
Y Public•S , 8000OK
Notar P tate Of FloridaFtond (votary Public-State of Florida f
° —T11l�Gnmm_c � rr–zv
Commission#EE 176869 a EF 176869
i`�O Gln'O� ��fE•Ot i\n � Commissu:n
Revised 0%/1x/20 Bonded Through National Notary Assn. """ Bonded Through N,;,ona'Notary Assn.
REVIEWS I FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE f MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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