HomeMy WebLinkAboutBuilding Permit Application 4 1
ALL APPU i LE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I. Permit Number:
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Building Permit Application
Planning d d Development Services
Building an Code Regulation Division
2300 Virgh id Avenue,Fort Pierce FL 34982
Phone:Q 2)462-1553 Fax: (772)462-1578 Commercial (Residential �C
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
RLAddress:
Legal Description: '�y b Z AT +u4-- &se:AwE Lar (�
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Property Tal ID#: 3 320 - Za �"ZA O�^ I Lot No_ 17
1l a-1oA soplE
Site Plan Name: 13, Block No.
Project Na e:
Setbacks Front Back: Right Side: Left Side:
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Additional oor to e e orme under this permit=cneCK allappy:
❑HVA Gas Tank Gas Piping Shutters Windows/Doors
Electi,is ElPlumbingSprinklers EIGenerator Roof
Total Sq. Ftlpf Construction: S Ft.of First Floor:
Cost of Coni truction:$ [ q % Utilities: _Sewer Li Septic Building Height:
Immi 21111
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Name 1 l era AS OP(le Name: Peter A Cafaro III
Address:. .HIL4 : 6&l—V'Y Company: Lowe's Home Centers, LLC
City: pvk `A- State: R- Address: P.O. Box 781993
Zip Code: 3�� Fax: '` City: Orladno State:FL
Phone No.i Zip Code: 32878-1993 Fax:.
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E-Mail: Phone No. 777.-i 4*8- 3(. S
Fill in fee simple Title Holder on next page(if different -E-Mail: L P'F'('.AX Y�wv• �^�
from the Owner listed above) State or County License: CGC1508417
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If value of c9!nstruction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip Phone: j Zip: i Phone:
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FEE SIMPLE TITLE HOLDER: YNot Applicable BONDING COMPANY- Not Applicable
Name: Name:
Address: Address:
City: City: l
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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 the permit holder to build the subject structure
which is irk conflict with any applicable Home Owners Association rules,bylaws or and Sovenants 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 accessoryuses 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 o orney before
commencing wor recordi Notice of Commencement. j
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Signature of Signature o Contra r/ ' nse Hol
STATE OF FLORI/ ent/Les a STATE OF FLORI A
j COUNTY 01 SLC COUNTY OF 51
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i The foreoing instrument was�cknowled ed before me The forgoing instrunlent was acknowledge ore me
thi ay of tG 20 y this �Oi-�iay of (�fr� 20 by
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Peter Cafam III ���� Peter Calaro III
i (Name of pyo ackrim ging) (Name of person ac�rie Ln
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(Signature of Notary Public-State of Florida) (Signature of otary Public-State of Florida)
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Personally Known x OR Produced Identification Personally Known x I OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. 5;"
Se Commission No.
( MhCH BOCOOK I ;" BO
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+ ;r COOK f
Notary Public-State of Florida ••`<'_ Ni lary Public -State of Florida
� Expires H1ar- , -'Commission k EE 176869 "�� a; 'commtssa,n d EE 176869
Revised 0%/15/2Bonded Tnrouon Nalmnal Notary Assn, , Bonded Througn rr,;,onal Notary Assn.
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REVIEWS I FRONT ZONING SUPERVISOR I PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW I REVIEW I REVIEW REVIEW REVIEW REVIEW
DATE I I
RECEIVED
DATE
COMPLETED
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