HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: t7�i (.p ' Permit Number: ( (1Q�'lJL/0 D
9�LUC E W
O
� Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential. X
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax:(772)462-1578
PERMIT APPLICATION FOR: Pool Deck extension
PROPOSED_IMPROVEM.ENT LOCATION;.`., ,
Address: 5624 Spanish River RD
Property Tax ID#: Lot No.
Site Plan Name: Johnson Pool Deck Block No.
Project Name:
DETAILED DE-SCRJPTION''OF WORK:'
Pool Deck fill inwdli 606 b
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION
Additional work to be performed under this permit—check
k all that
t apply:_Mechanical _Gas Tank ,Gas Piping _Shutters _Windows/Doors _Pond
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: 275 Sq. Ft. of First Floor:
Cost of Construction:$ 3200 Utilities: —Sewer Septic Building,H.eight:
OWNER/LESSEE. CONTRACTOR:
Name Milton Johnson Name:Kenneth I. Lippard
5624 Spanish River Rd .Li and Construction Inc.
p RP.
Address. Company.
City: Fort Pierce State:_ Address:1200 Driftwood Lane
Zip Code: 34951 Fax: City: Fort Pierce State Florida
Phone No.561-261-3601 Zip Code: 34982 Fax: 772-465-6739
E-Mail: Phone N0772-370-7548
Fill in fee simple Title Holder on next page(if different E-Mail lippardconstruction@comcast.net
from the Owner listed above) State or County Lice rise CGC1515384
If value.of construction is 2500 or more,a RECORDED Notice of Commencement Is required.
1f value of HAVC is$7,500 or more,a RECORDED Notice of Commencement is required.
-SUPPLEMENTAL CONSTRUCTION LIEN,LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: `Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: ^Not Applicable
Name: Name:
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 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 paying twice for
improvements to your property. A Notice of Commencement must be'recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attorney before commencing work or recording our•Notice of Com t.
"Sign ture of Owner[L e&tonWor as Agent for Owner Signature of Contractor/Lice se 006r
STATE OF FLORIDAb_U STATE OF. Lucie., OUNTY OFORID f - i ,, uej
COUNTY OF • 'I' UlA"
Sworn to(or affirmed)and subscribed before me of Swo,7 to(or affirmed)and subscribed before me of
Physical Presence or Online Notarization V P yslcal Pr se ce or Online Notarization
this�day of 2020 by this day of�i'o►y 2020 by
Leh . UppNrA K.e'nne+k IV Upp04 M
Name of person making stitelment. Name of person making statement.
Personally Known V OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produce4, Produce
June McLauqhfin Tufte McLa hli
(Sieaturl of Wotary Public-State of Florida) (Signature of dotary Public-St
t.FY PUB JULIE MCLAUGHLIN
;:�oaY Po'••, r%�L� Notary Public-State of Florid
e . J LIE MCLAUGHLIN '
Commission No. =_°• ,- N �r� Commission No. o (Se*ission#GG 341551
ublic-State of Florida '� o:'
a` Commission„"GG 341551 of r?• My Comm.Expires Jun 4,2023
My Comm.E Bonded through National Notary Ass .
Bonded tbroug National Notary Assn.
REVIEWS FRONT O 1 PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATEI(�
RECEIVED
DATE
COMPLETED
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