HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE eCm t Number: 1100 9
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Building Permit Application SEP 12 20,16
Planning and Development Services
Building and Code Regulation Division PER;,!fJTTJJqGSt. Lucie Count
2300 Virginia Avenue,Fort Pierce FL 34982 y, FL
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential )—
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line W-jtyoaw
PROPOSED IMPROUtVIEiVT�L®CON �� n
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Address: '2RI Z 'jhe✓w�oa La
Legal Description: �y\e_✓.r w 4 AC_~r_z,a "s. i
..Property Tax ID#: 1-o\ - C=1 O ' OC30 LJ Lot No. (�
Site Plan Name: 1Mpk J 'tel 43s-PEiE+rzf. Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
�DETAI}LED DESCR�IPTIO,R1 ®�FK
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CONSTRUCTION`INORM'ATION:
Additional work to Fe—pertormedunder tispermit=check all appy:
❑HVAC Gas Tank Gas Piping _Shutters Windows/Doors
❑Electric ❑Plumbing Sprinklers El Generator ❑Roof
Total Sq. Ft of Construction: Scl. Ft.of First Floor:
Cost of Construction:$ LtV( Utilities: Sewer ElSeptic Building Height:
DOWNER/LESSEE - t. CONTRACTOR:
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Name (mss LL�11 0"5 &d, Name: Peter A Cafaro III
.Address: •- l 2 :' '1' �r.rc�ot) "�—'" Company: Lowe's Home Centers, LLC
City:' +'02 �,� State: R- Address: P.O. Box 781993
Zip"Code: $2 ' ':'Fax: City: Orladno State:FL
Phone No. 17Zip Code: 32878-1993 Fax:
E-Mail: Phone No. 3�15-
Fill in fee simple Title Holder.on next page(if different E-Mail:
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/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
t
FEE SIMPLE TITLE HOLDER: of Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
I Zip: Phone: Zip: Phone i
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 prop�rtA Notice of Commencement must be recorded and posted on the jobsite
before the first ins ec . intend tp o obtain financing, consult with lender or orney before
commencing wor recorr Notice of Commencement.
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Signature of / ent/Les ee Signature o Contra r/ ' nse Hol
STATE OF FLORI STATE OF FLORI,A
COUNTY OF Sic COUNTY OF SLC
I
The foreoing instrumept was gcknowled ed before me I The forgoing instrurq! >;was acknowledge P ore me
this -day of r tn� .20 y this ay of 1j6n� 20_LLEby
i Peter Cataro III - + Puler Ca`ara III
(Name of o ackno% ging) (Name of persona in
(Signature of Notary Public-State of Florida) (Signature of otary Public-State of Florida)
I
j Personally Known x OR Produced Identification Personally Known 1: OR Produced Identification !
Jl! Type of Identification Produced Type of Identification Produced
( t7 MCH B0000K i BOCOOK
Commission No. Se ommission No.
Notary Public •State of Florida ;e•i •• Notary Public-Slate of Florida
--- — Y:• :--fY1y_Comm_-Expiccs-A4ar 7�'8t8 — _�' 3 mm-Fr H
Commission#EE 176869 s��F F r' Commrss on # EE 176869
af or n.r� Or• ••
Revised 07/15/2 0 " Bonded Through National Notary Assn. "1O Bonded Through N,,:,ona�Notary Assn.
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REVIEWS FRONT ZONING I SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
fDATE I
RECEIVED
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COMPLETED