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HomeMy WebLinkAboutBuilding Permit Application I ALL APPLIi i LE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I 11--II Date: I Permit Number: Building Permit Application Planning Q d Development Services Building at Code Regulation Division I 2300 Virgil ra Avenue,Fort Pierce FL 34982 1- 4 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential o PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line - I Address: Z0,01 ? 12 i` /I k A Legal Description: Property Tal ID#: 327 i I - oQ 5 I Lot No. Z u Site Plan Name: 9*A A44,mv: Ce Block No. Project Na I Setbacks Front Back: Right Side: Left Side: I i I -AdditionaliMror to e e Orme un ert ispermit-checka appy: ❑HVA Gas Tank Gas Piping Shutters Windows/Doors Elect is Plumbing Sprinklers Generator Roof I Total Sq. Ft; f Construction: S Ft.of First Floor: Z 5- I (� Cost of Construction:$ Utilities:"nSewer' Septic Building Height: Nam -55 _ - Name C&A Name: Peter A Cafaro III Address:. Company: Lowe's Home Centers, LLC City:' �o � C State: IF Address: P.O. Box 781993 Zip Code: K 9 to ' Fax: ' City: Orladno State:FL Phorie No.it R'g-0. e.90. &•o ZZ Zip Code: 32878-1993 Fax: i E-Mail: iI Phone No. 772��L118-3e9,' it Fill in fee sl pie Title Holder on next page(if different E-Mail: -T ?`_ �LP�wnc4s yQ f4w. from the O Iwner listed above) State or County Licdnse: CGC1508417 !� If value of co struction is$2500 or more,a RECORDED Notice of Commencement is required. i i I I ' I SUPPLEMENTAL CONSTRUCTION LIEN LAW IN,FORMATION: . DESIGNER ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable f Name: Name: Address: I Address: I i City: State: ! City: State: LZip: Phone: i Zip: Phone: — FEE SIMPLE TITLE HOLDER: of Applicable BONDING COMPANY: Not Applicable I Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: 'I 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. i 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 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 wit lender lender o orney before commencin wor recordi Notice of Commencement. i 1 Signature of kwaklfSignature o Contra, r/ nse Hol I STATE OF FLORI/ ent/Les a STATE OF FLORI I A ! COUNTY OF SLC COUNTY OF SLC 1 I The foreoing instrumeP[was�cknowled ed beforel me The foraoing instru I nt was acknowledge ore me this�i'3t(Slciay of `"5��7 20�oy this �✓Dtlay of 20 by i jPater Cafaro III Peter Ce'aro III f (Name of p e ackno ging) - (Name of person ac to (Signature of Notary Public-State of Florida) (Signature of ota�,y Public-State of Florida) j I Personally Known x OR Produced Identification Personally Known x; OR Produced Identification Type of Identification Produced Type of Identificatidin Produced Commission No. 0 (Se&>�CH BOCOOK Commission No. I' "' B0004K t Notary Public-State of Florida l},r q. �. Notary Public -State of Florida r'• `�� —EXpI[�6 Nt3r-t-H N f . - r-7-2tT fs Commission #EE t I6B69 I %:f ? Commiss,on a EE 176869 O„Or r� , wri . Revised 07/15/20 ”" Bonded Tlrough National IN Assn. I �" Bonded Througn n,;anal Notary Assn. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION: SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE l i RECEIVED I DATE COMPLETED � I '