HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: -I ° O Its Permit Number: ® _ (I
I B,
ECEWEDBuilding Permit Application SEP 12 2016
Planning and Development Services PER.:A1TTiNG
Building and Code Regulation Division St. Lucia Count;. ?_
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 fe C&-
P,ROPOSED I'MPRQVEMfNT L®,C:ATL®N.: + ; 4,. { r
Address: LO Li :56 51'-o A ✓
Legal Description: fj _IJer pA'✓%A. �w it 4 Ae`)S 61U_-P,-
Property
-Property Tax ID#: �JL(jOt - -5to5- yt_-!L b - Ody" y Lot No.
Site Plan Name: WWQ A IeAr- CI....kSO-1 Block No. ? 2-
Project
Project Name:
Setbacks Front Back: Right Side: Left Side:
'D`ETAILED DESCRIPl
Z 5LCTik4- % o,-
V
CONSTRU'CTION`INSF'`O'RMAT�ION• "'' =` c
Additional work toe e Orme un ert Is permit=c ec a appy:
HVAC ID Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
Electric ❑Plumbing Sprinklers ❑Generator Roof
Total Sq. Ft of Construction: Scl. Ft.of First Floor:
Cost of Construction:$ `I'1 K 3 Utilities: SewerEl Septic Building Height:
OIUNER/LESSEE
P..
Name Name: Peter A Cafaro III
Address: Ito IL4- S� ?off�pq. ,.�.Y Company: Lowe's Home Centers, LLC
City:" ��Ya' ` '�-"rQi State:�L Address: P.O. Box 781993
Zip Code: _2)4�i''d' ` 'Fax: ` City: Orladno State:FL
Phone No. ''1'12 -.�7i � v 3 Zip Code: 32878-1993 Fax:
E-Mail: Phone No.
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License: CGC1508417
1 11
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
= S
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
FEE SIMPLE TITLE HOLDER: of Applicable BONDING COMPANY--- Not Applicable
Name: Name:
Address: Address:
City: City:
LZip: 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 irl 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 ' rt' yo intend to obtain financing, consult with lender or orney before
commencing worl recordi Notice of Commencement.
i
I
Signature of / ent/Les e Signature o Contra r/ ' rise Hol
STATE OF FLORI STATE OF FLORI A
COUNTY OF S1C COUNTY OF Sic
jThe f�re ing instrumerwas�Icknowled ed ey ret me The fgoing instrurr>Pnt was acknowledger�before me I
this of 4- 20 this day of !!5 � 20�by
i
Paler Cafarn III I Peter Ca.'aro III
(Name of p :sa ackno% ging) - i (Name of person ac /gtn
.�'�� /�=� -1' ./" fir••-:_-_
(Signature of Notary Public-State of Florida) (Signature of otary Public-State of Florida)
Personally Known X 01 Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
I
( MhCH BOCOO
Commission No. Se K ! ommission No._ BOCOOK
Notary Public •State of Florida :<• Notary Public •State of Florida
�yly_Comm_ExPiro&-talar-7;2Bt6 - 1 CIIm _
o r Commission rY EE 176869 Commt� Hsr7-2018
ss:on d EE 176869
Revised 077155120 rrr Bonded Through National Wary Assn Banded Througoh,,I,onaiNotary Assn.
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REVIEWS FRONT ZONING7 SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW I
DATE 7
I RECEIVED
DATE
COMPLETED. I _�