HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �(
Date: I t I Permit Number: RECEIVED
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Building Permit Application AUG 2 2 2016
Planning and Development Services
Building and Code Regulation Division PEFiFMTTII�G
2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie County, FL
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential
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PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Address:
Legal Description: CA(Ips.� J4
Property Tax ID#: 3 2>7-t Z cx3i O - O0y- O Lot No.
Site Plan Name: K 6hA ; SzEwSk� Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
'L?ETAILED DESCRIPTION,OF1N®RK, W-7. �~'"' "
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CONSTR(JCTION 1N'FOYRiVI
Additional work to be nertormed under this permit check all t=appy:
HVAC Gas Tank E]Gas Piping _Shutters 14N Windows/Doors
Electric 0 Plumbing Sprinklers FIGenerator F]Roof
Total Sq. Ft of Construction: SFt of First Floor:
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Cost of Construction:$ ) f7 Y `9� Utilities: Sewer Ll Septic Building Height:
OVVNERJLESSEE �� , CONT ATOR = �
3..
Name L�iYce �►'LA-i i~��&wSw_; Name: Peter A Cafaro III
Address: __l.3 1 Z8 Company: Lowe's Home Centers, LLC
City:' State: Address: P.O. Box 781993
Zip Code: 349°ub 'Fax: ' City: Orladno State:FL
Phone No.,.1 72 `-'.Jf to-9 "7Z 7(&-- Zip Code: 32878-1993 Fax:
E-Mail: Phone No. '71Z - Lll S - 3091? _
Fill in fee simple Title Holder on next page(if different E-Mail: J_PG-L Pow(J.-S& 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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGONEER: i!Not Applicable MORTGAGE COMPANY: Not Applicable
i Name: Name: ---
1 —
Address: _ : Address:
City: _T State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: ,Riot A licable BONDING COMPANY: Not Applicable
Name: _ _ Name:
Address: I 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 theermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or angcovenants 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 orrice 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 o `torney before
commencing wort' recordi z `Notice of Commencement.
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S.gnature of w lei// ent .eee Signature o Contra '.,r/ ztrnse Hol jer'
STATE OF FLORIID&_--' i STATE OF FLORI'A/
COUNTY OF s _ — COUNTY OF s_c
The f%�}ja�omg mstrume It was�cknovvlecl-end before me The r�mg instrum nt was acknowledge ore me
this L'Whda of 20 b r this Clay of ,2r? Eby
Paler ca,am III `,,,�^"�"` •Cvar;W
("Jame of peir acknot' g,ng) - 'Name of person ac oo lno
(Signature of Notary Public- Starte of Florida) (Signature of Notary Public State of Florida)
Personally Known } OR Produced identification Personally Known OR Produced Identification
Type of Identification Produced Tyne of Identification Produced
Commission Na. ".
IS
BOCOOn Commission No.
e` Notary Public •Slat,'
o.flonda'i 1`Yo;ar P
e y ubl,c Slate o!Florida
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I�e�'Itied 07/115`20 •°• iienr,e r.;ra;or+h.,honal lJotary Assn �_"°`° Bonded Tnrc.
o3r;r•,..,„nz �Sotary Assn
REVIEWS FRONT ZONING SUPERVISOR ' PLANS VEGETATION ' SEA TURTLE MANGROVE .
COUNTER iREVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
RECEIVED
DATE- ----------,— - -- ` — - - - ----- �—---- —---- ---- —,
COMPLETED ` i