HomeMy WebLinkAboutBuilding Permit Application i
ALL APPLICABLE INFO MUST BE COMPLETED F.OR APPLICATION TO BE ACCEPTED (II
Date: (?—a I I LP Permit Number: 1 jos-Coo
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
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2300 Virginia Avenue,Fort Pierce FL 34982 j
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the endl of linePARN
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Address: --?� 3 % `Soh• 5 +., SJr"
Legal Description: ltd ?'AA A �Jtv--,5 Ln 7—
Property
Property Tax ID# Lot No.
�-x{,03 � �yZ - O��(o " ��' S� �
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Site Plan Name: T-A�—NA LAmore,nZl� -��E�Ez Block No. J�
Project Name:
Setbacks Front Back: Right Side: Left Side:
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Additionalwork toe e orme under this permit-c ec a appy:
HVAC LJ Gas Tank ❑Gas PipingShutters Windows/Doors
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Electric ❑Plumbing Sprinklers Generator - I Roof
Total Sq. Ft of Construction: S . Ft. of First Floor:
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Cost of Construction:$ 1 7 �" Utilities: _Sewer E]Septic JBuilding Height:
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Name ;r,-A LAwwv e,,n — IvAL Name: Peter A Cafaro III
Address: $1 � bN-ana .-,+- Company: Lowe's Home Centers, LLC
City: f:r7 ctek . State:�'L Address: P.O- Box 781993
Zip Code: "3 X145 2 Fax: City: Orladno State:FL
32878-1993
Phone No. X72—Ztto- 1(3.9 2 Zip Code: Fax:
E-Mail: Phone No. S!o i - 72 1- ;fib 1 1
Fill in fee simple Title Holder on next page(if different E-Mail: Co,.,
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.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable i
1 Name: Name:
Address: I Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: of Applicable BONDING COMPANY: Not Applicable
Name: 4=14Name:
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 iNconflict 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
commencingwor recordi Notice of Commencement._
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Signature of kwjief/ ent/Les e Signature o Contra r/L nse Hol i
STATE OF FLORI STATE OF FLORI A
COUNTY OF sic COUNTY OF st_c
The forgoing instrument was�cknowlecled efor me I The forgoing instru nt wits acknowledge ore me
this?AKday of C .'`t 20 by i this�ay of 20LLA by
jPeter Cafaro III J„J' I Peer Ca`aro III
E (Name of pe-rsoackno ging) - (Name of person ac o In
(Signature of Notary Public-State of Florida) (Signature of otary Public-State of Florida) j
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Personally Known X OR Produced Identification Personally Known x OR Produced Identification
j Type of Identification Produced Type of Identification Produced
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(SeajhCH 80COOK Commission No. `""" :ThrougN,",;11ria'Nofary
BdC00K
Commission No. _
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Notary Public•State cl Florida `<eF * ' NotaState of Florida
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My—G.nmm Fxpi '-N �=TCommission#EE 176869 • . ao Cod EE 1768fi9
7 �•'�inral• ��rnnra`Revised 07/15/0 Bonded Thr.g-h NaliQnal Notary Assn. Bonded Assn.
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