HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: a(Ztp� I(P Permit Number:
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
PROPOSED INIPR01/EMENT LO:E`'ATIO :, ,
Address:
Legal Description: 4z ^c 5%y--S
Property Tax ID#: �i(2�' �o - o 3 do- 0 00 - .� Lot No.
Site Plan Name: `�..01 -AtJruT.2_� Block No. 8
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF VURK
�:a�•Nr •f w��
CONSTRUCTION INF�O'RMA�TION: �V "'
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Additionalworkto e e orme under this permit_c ec a appy:
HVAC f Gas Tank ❑Gas Piping _Shutters a Windows/Doors
Electric 0 Plumbing Sprinklers FIGenerator E]Roof
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ C/ Utilities: SewerEl Septic Building Height:
O)NNER/LESSEE
TRTR
n :.
Name .J ,rd 1�� L y r V •1,z i Name: Peter A Cafaro III
Address: 53 Z 0 -:-C— l.. Company: Lowe's Home Centers, LLC
City: � k S'I� L v� State:�L- Address: P.O. Box 781993
Zip Code: `} q fL 'Fax: City: Orladno State:FL
Phone.No. Zip Code: 32878-1993 Fax:
E-Mail: Phone No. 2 7 Z -`f/ - 3 (o It S�
Fill in fee simple Title Holder on next page(if different E-Mail: T IP(g, (_ ��2r�n � �_�(O
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.
AV
SUPPLEMENTAL
CONSTRUCTION LIEN LAW INFORMATION:
i DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
I
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
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 property. 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 orney before
commencing won recordi Notice of Commencement.
Signature of&AaAaf/ ent/Les a Signature o Contra r/ " rise Hol
STATE OF FLORI STATE OF FLORI A
1 COUNTY OF SLC COUNTY OF SSC
The foreoing instrument was?cknowled eg d before me The forgoing instrumgrit was acknowledgerj p�fore me
this�fd�day of 20 by this 24>w�lay of r � 20 by
I
i Peter Cafaro III �,r Peter Ca'aro III
{ (Name of petro acknot gmg) (Name of person ac gin
(Signature of Notary Public-State of Florida ) (Signature of otary Public-State of Florida)
Personally Known X OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced `
Commission No. "";",w, (SeMhCH BOCO ommission No. I
OK " BOCOOK
Notary Public-State of Florida �`• _ Notary Public -State of Florida
• 7�Cnmm—ExP e5-A4ar 7��16 �• Gamm_F,p.0--"I ?�$}g
Commission #EE 176869 Commiss cn u EE 176869
'• ,° ;` �
Revised 0%/1 5/?0 Bonders ihrouoh National Notary Assn, """ Bonded Through h•,;;ona:Notary Assn.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED — �
DATE
COMPLETED