HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: A I O 1(� Permit Number: -3.
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_, 1v RECEIVED
' MAR 0 8 2022
Building Permit Application St.Lucie County
Planning and Development Services Permitting
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax:(772)462-1578 Commercial Residential XXX
PERMITTYPE:Siab Permit for a future detached garage
PROPOSED IMPROVEMENT LOCATION:
Address: 1200 Driftwood Lane, Fort Pierce FI,34982-3316
Property Tax ID#: 3404-808-0004-000-2 Lot No.
Site Plan Name: Lippard Block No.
Project Name:
DETAILED DESCRIPTION Of WORK:
form and pour a slab for a future detached garage
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors
_Electric _Plumbing Sprinklers _Generator =Roof 5/12 Pitch
Total Sq.Ft of Construction: 783 Sq. Ft.of First Floor: 783
Cost of Construction:$ 7800.00 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE; CONT.RACTOR:: .
NameKenneth I. Lippard Name:Kenneth I. Lippard
Address:1200 Driftwood Lane Company:Lippard Construction Inc.
City: Fort Pierce State:T Address:1200 Driftwood Lane
Zip Code: 34982 Fax:772-465-6739 City: Fort Pierce State:F1
Phone No,772-370-7548 Zip Code: 34982 Fax: 772-370-7548
E-Mail:lippardconstruction@comcast.net 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 License CGC1515384
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
1-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 YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR 140TICE OF CO ENC ENT."
Signature of Owner/Lessee/Contractor as Agent for Owner Signature 6f tAtrii6WLic e H d
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF _ • ��)�,
The forgoing instrument was acknowledged before me The going instru ent was cknowledged efore me
this day of 20_ by this day of 20Q64v
Name of person making statement. Name of person making stateme . /
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identificat� /
Produced Produced C.e
1
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(Signature of Notary Public-State of Florida) (Signature of Notary ublic- tate of Florida)
Commission No. (Seal) Commission ,,;PsYPi6"' KAREN S. N¢F €N
cz �; lorida-NbI QPublic
i= Commission # GG 207484
June 12, 2022
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