HomeMy WebLinkAboutBuilding Permit Application 1;-23 Y1
ALL APPLI I LE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: fill QI Ito Permit Number:
I I
RECEIV7_1 DEC 12 2016
Building Permit Application
Planning d d Development Services
Building and'dCode Regulation Division
2300 Virginn�ia Avenue,Fort Pierce FL 34982
Phone:(7�2)462-1553 Fax: (772)462-1578 Commercial Residential
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PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line IN;Psflo,-i s
Address: 5 J_N o 1-1 o
Legal Description: 1,�1 1 �S 1 0� N II2 %- t4
Property Tj� ID#: 13%1.1 .a)12- 6 o OI^ oZ Lot No.
Site Plan Name: V.1%GA- Block No.
Project Na e:
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Setbacks Front Back: Right Side: Left Side:
HIM
r 13 n „AIA- L9%;nq cam;
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bona ork to be performeJ under this permit=checValap
py:
❑HVA Gas Tank Gas Piping Shutters A Windows/Doors
Elect is Plumbing Sprinklers E]Generator E]Roof
Total Sq. Ftp f Construction: S .Ft.of First Floor:
Cost of Con�truction:$ 1 LZto g Utilities: _Sewer Septic Building Height:
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Name i ' Name: PeterA Cafaro III
Name
Address:, ^R�}- 0 S:.► ��r:a c� Company: Lowe's Home Centers, LLC
City:' ► -� State:_ Address: P.O. Box 781993
Zip Code: II 3 'Fax: ' City: Orladno State:FL
Phone No.i 7 7 Z ' .Z I' cf 8�� Zip Code: 32878-1993 Fax:
E-Mail: Phone No. -772 4IS- 569'9
Fill in fee+ple Title Holder on next page(if different E-Mail: �r!PG (2— ✓/whoa • co VNfrom the O�wner listed above) State or County License: CGC1508417
it
If value of co struction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW-1 N FORMATION:
DESIGNER/ENGINEER: !Not Applicable 1 MORTGAGE COMPANY: Not Applicable
Name: I Name:
Address: ' Address: I
City: State: City: State:
Zip: Phone: Zip: Phone:
I FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
j
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 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 or orney before
commencingwon recordi Notice of Commencement. _
Signature of Signature o Contra r/ nse Hol
STATE OF FLORI/ ent/Les a STATE OF FLORI A
j COUNTY OF SLC COUNTY OF SLC
jThe forgoing instrument was 4cknowled ed beforet me The forgoing instruAQ�nt was acknowledged Wore me
j this'Wday of 20iv
y thisiday of V&__ 20by
i
Peter Cafarn III i Peter CafaroIII
(Name ofp�yso acknot, ging) i (Name of person ac vTea n
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(Signature of Notary Public-State of Florida ) (Signature of otary Public-State of Florida} l
Personally Known X OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. (SeMhCH BOCD76�
commission No. BOCOOK
�• •� Notary Public -SlaFlorida Notary Public -Slate of Florida
xpic�5 - • t yes f tori tt1t6 F �,;, Commission k ECommtss un a•"'0.";, '•''er�,` EE 176869Rc ViSzd 0%/I S/20 Bondea 7hrouoh Nationa '" Bonded Through 11' itJnal Notary Assn.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
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