HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:i l•a.)_ ILO Permit Number: (0 I 1,1 L) l�/✓
RECEIVED
Building Permit Application NOV 2 9 2015
Planning and Development Services PERIdJITTING
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of linequM6,0
PC)IxOS x d ) ' g1!£ iNT LaCATIaIV. rA
Address: 6105 RAINTREE TRL, FT PIERCE, FL 34982
Legal Description: LOT 34. BLOCK 71, INDIAN RIVER ESTATES UNIT NINE (MAP 34/11S) (OR 3614-2480),
Property Tax ID#. 3402-610-0056-000-3 Lot No. 34
Site Plan Name: Block No. 71
Project Name: INDIAN RIVER ESTATES
Setbacks. Front Back: Right Side: Left Side:
01'A(11� -.,SR(RT(Q +� WOFtIR
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c 1r�sT ucT � ( oRn TION 1U
Additional work to be ne ficrme d under this permit–checall appy:
QHVAC Gas Tank Gas Piping Shutters Doors Windows
— Q P g — Q Windows/
Doors
Electric 21 Plumbing Sprinklers Q Generator Roof Roof pitch
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ 300 Utilities:n Sewer OSeptic Building Height:
Name US BANK Name: KENNETH I LIPPARD
Address:800 MORELAND ST Company: LIPPARD CONSTRUCTION INC
City: OWENSBORO State:KY Address: 1200 DRIFTWOOD LANE
Zip Code: 42301 Fax: City: FT PIERCE State:FL
Phone No.270-691-3245 Zip Code: 34982 Fax: 772-465-M9
E-Mail: Phone No. 772-370-7548
Fill in fee simple Title Holder on next page(if different E-Mail:
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.
a
-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:
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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our ' e of Commencement.
s
ignature 6f Owner/ e / ractor as Agent for Owner gna ure o o ac or/ ense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF—S k- L J C.1.-Q, COUNTY \ Uc\e
The forgoing instrument was acknowledged before meI The forgoing instrument was acknowledged before me
this day of N O V 20�by this ZA day of_ {S 20 by
k c-n�.-�1r1 L��U P �C� �.'z v.-�►�-�"�� L-�� 8.,P a�
(Name of person acknowled n ) (Name of person acknowledging)
(Signature of Notary P lic-State of Florida) (Signature of Notary P lic-State of Florida)
Personally Known OR Produced Identificatio Personally Known OR Produced Id
Type of Identification Produced Type of Identification Produ EGIVEN
W. OVUo.
Commission No. � �► ow►u otels ommission No.Deo -:e ML -� �S��twe2n„�eTs
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS