HomeMy WebLinkAboutBuilding Permit Application t1�b3
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:I lDO O ' �EJyL'1
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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:
Legal Description: Cr. ,o*;k4.4 C-15 tc%�ES u,.%-1k Vv- '57
Property Tax ID#: 31J0'2.- 609 - ot S 3 -000 ' Lot No. 5
Site Plan Name: Tor►. "-A4^" Block No. 51
Project Name:
Setbacks Front Back: Right Side: Left Side:
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i lona wore to e e Orme un er this permit—check al appy:
HVAC Gas Tank ❑Gas Piping _Shutters F]Windows/Doors
nElectric 0 Plumbing Sprinklers Generator F]Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ H I q i'( Utilities:o Sewer E]Septic Building Height:
Name TbY N L 8nf A" Name: Peter Cafaro III
Address: 1540 3 �,"c. �' Company: Lowe's Home Centers, LLC
City: r-r PI tCC& . State: F� Address: P.O. Box 781993
Zip Code: 3��2 Fax: City: Orladno State.FL
Phone No. (P0-1 - S 3 r Zip Code: 32878-1993 Fax:
E-Mail: Phone No. -11L-M(f$-3�o4S
Fill in fee simple Title Holder on next page(if different E-Mail: _t.##.&-I A-s a a&oo.Ca'"`
from the Owner listed above) State or County License: CGC150 17
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
I Address: Address: _
City: State: City: State:
I�I Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: Plot Applicable BONDING COMPANY: Not Applicable
Name: Name:
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 irt.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 inspecyo intend to obtain financing, consult with lender or orney before
commencin wor recordi Notice of Commencement. _
Signature of j. ent;`Les e I Signature o Contra r,/' nse Hof
STATE OF FLORI i STATE OF FLORI A
COUNTY OF COUNTY OF sw _
The foreoing instrume t was ocknowled ed eforer me The farsoing instrurr_Wnt was acknowledgesore me
this &ay of tj- 26 y thisaj&ay of d 120y
i
Peter CaFarU III 011
Peter Ca.'ar-)Ill
(Name of p - (Name of person ac gin
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7�,-_ ging)
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(Signature of Notary Public-State of Florida ) (Signature of lNotary Public-State of Florida)
Personally Known X OR Produced Identification ! Personally Known x OR Produced Identification
Type of identification Produced i Tyor of Identif;cation Produced
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( IiI�rC H B BOCG--,
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Commission No. Se r ommission Na _ BuCGC
Notary Public -Stale ei finnda! '?�• i,�`''. Notary Public-Slate a1 Florida
s e My COMM-Fxos JNa�t --- - - -' =Mu-Los-,,-�Yc _#ar 7 ?Bt6
f Comm ssion�EE 176869 ' F �r? Comm,ss r:: a EE 176859
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Revised G /1 5/20 ,,,"' BOnded a o ao Nelional Notary Assn Bonded Tt�rougn fi,.:ona'Notary Assn
REVIEWS I FRONT ZONING SUPERVISOR i PLANSVEGETATION SEATURTLE ! MANGROVE
COUNTER REVIEW REVIEW REVIEW 1 REVIEW REVIEW REVIEW
l_DATE
RECEIVED i
DATE i --
COMPLETED j L
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