HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION To BE ACCEPTED
Date: Permit Nw
SCANNED
BY
St. Lucie County
Building Permit Appl
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
Residential X
PERMITTYPE: detached Slab
PROPOSED -IMPROVEMENT LOCATION: -
Address- 1106 Driftwood lane
Property Tax ID #: 3421808`0005'000`4 Lot No. 5
Site Plan Name: Buck Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
Pour a detached slab in rear of property 10' from the left of the property line and 15' from the rear property
line -:? „ r in 11A fill : n v 1C I 1<2r-%::, YY%-f—_ k " . 1.9) 1-:1 1+
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
_ Electric _ Plumbing
Total Sq. Ft of Construction: 360
Cost of Construction: $ 1500
_Sprinklers _Generator
Sq. Ft. of First Floor: 360
Windows/Doors
Roof Pitch
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR: '-
Name Richard Buck
Name: Kenneth I. Lippard
Address: 1106 Driftwood lane
Company: Lippard Construction Inc.
City: Fort Pierce State: _
Zip Code: 34982 Fax:
Phone No. 772-240-2306
Address: 1200 Driftwood lane
City: Fort Pierce State:_
Zip Code: 34982 Fax:
Phone No 772-370-7548
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail lippardconstruction@comcast.net
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 it required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
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, 1 do hereby agree that 1 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 AMRNEY BEFORE RECORDING YOtJh NOTICE OF COMMENCEMENT."
ignat o wne ess Co tr cy r a Agent for Owner
Signature o Contracts r/Lic s old
STATE OF FLORIDA
STATE OF FLORID
COUNTY OF
COUNTY OF r
The forgoing instrumen was acknowledged before me
'Xithis,'0,; (� . . 20 A -by
The forgoing instr,4�enF was acknowledged,�efore me
this�day of (T -(7% . 20Vby
Name of person making statement. °
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification "
P/rod�u�ce�d,��,,,�
Prodyu�ced'/}�'���y
(Signature f otary Pub Art- of FI ida j
2����
��r/��1 '
(Signature a ofPublic- Stateof Florid )
•°••''•• AUDREY B. REY
Commission N ;'i?� "`•y4,= ��
:,_ MISSIONAGG 300811
'�e^r?•"'-• AUDREYB. HU Y
Commissioni.:s• "•�.: ���
a MISSION #GG 3�0817
.'.?
.''-:;�`•.= EXPIRES: March 6 202
o=
" EXPIRES: h1arch 6 2023
REVIEWS
"•%.:I,`,••' Bond
Thru Notary Public U
derwri[ersFP��;°'
ISOR
PLANS
Bon
VEGETPtTfOTtF`
ed Thru Notary Public Un
erxritars
N' ROVE
SfA rCi
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 21 // 19