HomeMy WebLinkAboutBuilding Permit Application i Y
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED zr_QZS
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Date: �� ( Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 `7
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential J(
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSEDIIVIPRQI/EMENTL®CATI��N:.
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Address: --707— KA"Ir e. C A-
Legal Description: �•ye-,r Le- Lk v-% (SIV, ZZ Low-
Property Tax ID#: 3"� L(t 9 Jam) - cos - ()(3c) - 1-( Lot No. I s
Site Plan Name: Gory' Block No. Z Z
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DE�SCRSIPTION`OFW{--+®RK . `4
Z_X-vyac�- moo" r A"40 � 1—„ ,�Ac-)- Wi.rou•J c�er+;hy+S
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CONSTRUCTION INFO"R�MATION: �..
Additional work to be nertormed under tis permit=c ec a apply: „ z
❑HVAC Gas Tank Gas Piping _Shutters Windows/Doors
❑Electric 0 Plumbing []Sprinklers ❑Generator ❑Roof
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction:$ �Z 2 `1'3 �'9 Utilities:Sewer❑Septic Building Height:
zOVUNERJLESSEE CONACf®R �
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Name ^ y-oName: Peter A Cafaro III
Address: w Z,..J;ny ni-€-Q4 Company: Lowe's.Home Centers, LLC
City: '{apr 4- J !c t.r State:FL Address: P.O. Box 781993
Zip Code: 3�g S”Z "Fax: City: Orladno State:FL
Phone No.' Q70 :,.z9'9 .3 Lf'q 1-f Zip Code: 32878-1993 Fax:
E-Mail: Phone No. ?7Z - 4t B- 3fo9 C
Fill in fee simple Title Holder on next page(if different E-Mail: TS'(o_ L p,��c►�:
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
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
i
r FEE SIMPLE TITLE HOLDER: of 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 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
commencin wor recordi Notice of Commencement.
Signature of kAaefSignature o Contra r/L' nse Hol
STATE OF FLORI/ ent/Les a STATE OF FLORI A
COUNTY OF SLC COUNTY OF SLC
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The foreoing instru ert was'�cknowlecled beforet me i The forsoing instrumqnt was acknowledge b_,efore me
this qday of 200 y this gZ4teLay of s4 20 LLA by
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Peter Cafaro III �.- I Peter Ca`aro III
(Name of peso ackno ging) - i (Name of person ac to
(Signature of Notary Public-State of Florida) (Signature of lNotary Public-State of Florida)
Personally Known x OR Produced Identification I Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
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Commission No. "'; (SeE6rCH BOCOOK I ommission No. BDaA
Notary Public -State o1 Flonda 'mac• Notary Public •Commission k EE 176869 Commissrtm .�� o1 i�n • "%;Fa,•�d Revised 0%/1S/20 "' Bonded Throuoh National Notary Assn. Bonded Tflreugh n,l
I REVIEWS I FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED `��