HomeMy WebLinkAboutBuilding Permit Application � II
ALL APPLI,ABLE INFO MUST BE COMPLETED.FOR APPLICATION TO BE ACCEPTED
Date: �iZ� 1 V/ 1 lG Permit Number:
I I
RECEIVED
Building Permit Application DEC 21 2016
Planning arld Development Services PERMITTING
Building an I Code Regulation Division 5t. Lucie County, FL
2300 Virgh iia Avenue,Fort Pierce FL 34982
Phone:( 2)462-1553 Fax:(772)462-1578 Commercial Residential X
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PERMIT�PPLICATION FOR: To Select from dropbox, click arrow at the end of line
Address: '7(oa Z
Legal Desc j!ption: �G-S��"r� ��A���'�'�b�, - p�-Au&_ t - 1-oT 27
Property Tai ID#: 5S7-1 MZ.-7- Q Lot No. Z�
Site Plan Name: -��� ��►.kr-�11 T' Block No.
Project Na ri e:
Setbacks i Front Back: Right Side: Left Side:
Additional� rk to enertormed under tispermit-check all appy: -
❑HVA C Gas Tank Gas Piping Shutters 21Windows/Doors
— P g —
Electic ElPlumbingSprinklers F Generator a Roof
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Total Sq. FtI f Construction: S Ft.of First Floor:
Cost of Coni truction:$ � � Z' Utilities. Septic Building Height:
MOM
Name li ey Co'.")c Y-El Vl' Name: Peter Cafaro III
Address:. .i� (.a_cteg_ - �-( .., W� Company: Lowe's Home Centers, LLC
City: , k- S�"Lvc�Stater- Address: P.O. Box 781993
Zip Code: I �g ��' Fax: '` City: Orladno State:FL
Phorie No. ��_ �OQ•5- .�-(l.Q3L Zip Code: 32878-1993 Fax:
E-Mail: I I Phone No. 77Z_ J41 t3- 3(69J
Fill in fee+' ple Title Holder on next page(if different E-Mail:�G.- L?f&4v" 1 As %ao. coo-.
from the Oiwner listed above) State or County License: CGC1508417
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If value of c' struction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: A Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: I City: State:
Zip: Phone: Zip: Phone: i
FEE SIMPLE TITLE HOLDER: Yt4ot Applicable BONDING COMPANY: Not Applicable
Name: Name:
G 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 irvconflict 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
commencin wor r recordi Notice of Commencement.
Signature of / ent/Les e Signature o Contra r/L' nse Hol
STATE OF FLORI STATE OF FLORI A
COUNTY OF SLC COUNTY OF SLC
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The foreoing instr ert was�cknowled eg d beforet me i The f�going instrum nt was acknowledgfJ me
this of C 20 y thi �IONay of 20 by
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Peter Cafaro III Peter Cafaro III
(Name of persa ackno ging) - (Name of person ac gtn
(Signature of Notary Public-State'of Florida} (Signature of lNotary Public-State of Florida)
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Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
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Commission No. n -,
(SeF6rr. BJCGOK Commission No. BOCOGK
Notar Public_ :" Notary
_ 1• = Y State of
Florida = '_ Y Public -Slate of Florida
- 'z—Fri"re4-Mar-T-2Bt8
Commission rr EE 176869
fpi n,.• IEws aR•' Commtss,on d EE 176869
Devised 07/1 S/20 ,�„'. Bondcd Tnrouon National Notary Assn, �""� Bonded Through R,I,onal Notary Assn.
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