HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED F.OR APPUCATION TO BE ACCEPTED
Date: [ ( 4 (,o Permit Number:
RECER'7D SEP 19 2016
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 5'h...k4
Address: cgs rn e 0 f +6 IC 01-*A- ,., �1 V0 N
Legal Description: L,.u,k 13Iwb 142 LT s Co
Property Tax ID#: p �LiN`i-SOt-. �']O�-Ooc��-� Lot
Site Plan Name: A��►'tio• Aq t4Ar-W1- SI Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
is rjsY
i I 3
_-,Apes. P Ane,( goe^: $
Additional work to be performed under tispermit=check all appy:
❑HVAC Gas Tank Gas Piping _Shutters ❑Windows/Doors
aElectric M Plumbing Sprinklers Generator 1-1 Roof
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 1q a Li Utilities: _Sewer Septic Building Height:
F*:N
Name L%a r►rly Name: Peter A Cafaro III
Address:: 8(0; AWVi. tt« 31✓9 N Company: Lowe's Home Centers, LLC
City:. YW State:�L Address: P.O. Box 781993
Zip Code: 3'J+gtrZ Fax; `' = City: Orladno State:FL
PhoneNo - Z' 2-' ,� 0�'. Zip Code: 32878-1993 Fax:
E-Mail: Phone No. '77 2 1119-3�q,�
Fill in feesimple Title Holder on next page(if different E-Mail: TPCo_ yam- -�•^�
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.
SUPPLEMENTALCONSTRUCTION.UEN.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
i 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 proper, . 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.
t
Signature of / ent/Les a Signature 0 Contra r/ rise Hol
STATE OF FLORI STATE OF FLORI A
COUNTY OF SLC COUNTY OF SLC
4
I
I The forgoing instrument was?cknowled a betore,me The f
going instrurrAgnt was acknowledge ore me
this A*eday of,�;�4 20 y this of 'S6g9;
20_W by
l
� Pater Cafaro III — i Peter Cataro III
(Nam�PaE!k!.n�oirng) (Name of person ac to
I
(Signature of Notary Public-Sta a 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. "':""'•. (SeWftCH BOCOOK ommission No. BOCOOK I
Notary Public-State of Florida =r• Notary Public -State of Florida
�. . . '
Cnmm-.Expir4s.Maf-7-2e-
Commission#EE 176869 �,�'e rin°•' Commtss:or a EE 176869
Revised 07/15/20 Bondea Through Nallonal Notary Assn. ""'� Bonded Througn ti•,1tona:Notary Assn.
REVIEWS FRONT ZONING f SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE ,
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW l
DATE i
RECEIVED
DATE I
COMPLETED