HomeMy WebLinkAboutBuilding Permit Application l
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED / 1
Date: (a�l / /_ SCD Permit Number: 0. 0 103.
INV
RECEIVE
Building Permit Application
Planning and Development Services OCT
12 2016
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 ooh
Legal Description: �A w1L Lk, Q i,44j L 8 ?Z LOT Z
Property Tax ID#: �� 1 9 ' SZD O Oct S'- ' O 00 Z Lot No. Z
Site Plan Name: "Ulf Ck✓Q N ZA Block No. 72
Project Name:
Setbacks Front Back: Right Side: Left Side:
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Additional work tone e orme under t is permit=c ec a appy:
HVAC ;El Gas Tank Gas Piping _Shutters windows/Doors
Electric Plumbing Sprinklers 11 Generator E] Roof
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Constructionl:$ 93 -7 41 Utilities:Cn Sewer O Septic Building Height:
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Name G'-�e,/L u rq,L.;ZA Name: Peter A Cafaro III
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Address: 3a.O.-A4. '560a Company: Lowe's Home Centers, LLC
City: �i✓k 5 f Lys; _ State:_PL Address: P•O. Box 781993
Zip Code: 31f 4�`+� 'Fax: City: Orladno State:FL
Phone No, 1J(d lo•.-_82 o(v Zip Code: 32878-1993 Fax:
E-Mail: Phone No. 77 2- 4(9 - 3(o ?5'
Fill in fee.simple Title Holder on next page(if different E-Mail: TPCs� LPg e.r1;-�s��►'Y'"'
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:
i DESIGNER/ENGINEER: _Not Applicable T MORTGAGE COMPANY: Not Applicable i
Name: Name: f
Address: Address:
City: i State: City: State:
l Zip: I Phone: Zip: Phone: I
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FEE SIMPLE TITLE HOLDER: of Applicable BONDING COMPANY: Not Applicable
Name: I Name:
Address: I Address: i
City: City: i
Zip: I Phone: Zip: Phone: '
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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 the permit 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 wilth 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
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WARNING T I 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 o orney before
commencing vvor recordi Notice of Commencement.
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Signature of / ent/Les a Signature o Contra r�nseftl
STATE OF FLORI STATE OF =LORI A
COUNTY OF 41-c COUNTY OF 5LC
The foreoing in Itrumelit was gcknowledgecLbeforl me I The fnraoing instrurrwnt was acknowledge ore me 4I
this ay of f?7rT 20 y this, day of Cr9C,'r 2o[r by
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Peter Calaro III _ i Peer Ca`aro III
(Name of p ackno ging) (Name of person ac to
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(Signature of(rotary Public-State of Florida) (Signature of lNotary Public-State of Florida) i
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
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ommission No.
Commission No. (SenlftcH 8000OK ,, .o, BOCOOK
Notary Public•Statc of Florida = • Notary Public -State of Florida i
L�___ N•• `;' Comm rxpoes mar 7zee -• ' '
Commission#EE 176669 .*. ,*A-' Commiss:vn a EE 176869
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"•` Bonded Throu n A.,%ona�Notary Assn.
Revised 0% 1$/20 ����•• Bondea Thrcuan National Notary Assn 9 y
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