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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED rn Date: Permit Number: I "709 ' CO ,�-_ � ; —� '§ Ick�•!/ SEP Building Building Permit Application 201,. Planning and Development Services PFR•". Building and Code Regulation Division St Lucke, oul 2300 Virginia Avenue,Fort Pierce FL 34982 - L Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: PtRQPOS€D INPRC►1/EME,` T LOCATItN jwit � } Address: IJ C'ZAftrl� !� -��L Legal Description: ( — &re' r�OG�.F�� �� I ��� 4,jd PropertTax ID#: Lot No. Z2 Site Plan Name: Block No.3 6) Project Name: Setbacks Front Back: Right Side: Left Side: t yDEWED' kip -��- - ILED DESCRIPTION CIPW�ORK E a ,�. w.A, TA r ` �o �7 , G JN l` 6tJ t'+ -�N i ct -: �fi. ,'. t'e'-u� "Ea;. , " �.qG f.4t CONSTRUCTlONt1NFORIVfATIfJN a kit 5 moi � � � r. � : �3a a ,� - :_ A ax.a - .. 'v Additionalworkto a per orme under this permit-check all that appy: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Electric _Plumbing Sprinklers _Generator _Roof Pitch ®Total Sq. Ft of Construction: (3 d'-{'. Sq. Ft. of First Floor: Cost of Construction: $ _ 2©0• D� Utilities: —Sewer _Septic Building Height: t� ame �b`•o a $1�?9}p 'r? a:�s bsicnSt °%'�—� ;' ..117710:}Qf41�•e�1 Address: Company: ,_ -., �£ City: State:_ Qdd�re'ss: ;;1t:i�!}'li!i101!}j Wfloo, '•ini:iii+"�,~ Zip Code: Fax: City: State: Phone No. Zip Code: Fax: E-Mail: Phone No Fill in fee simple Title Holder on next page( if different E-Mail from the Owner listed above) State or County License JEvalue of construction is 2500 or more,a RECORDED Notice of Commencement is required. PLANNING & DEVELOPMENT BOARD OF _ SERVICES DEPARTMENT COUNTY COMMISSIONERS , Building & Code M Regulation Division Residential Fence Affidavit of Compliance I, C., �� , intending to be legally bound, here y certify that work authorized by Permit Number 1709-0044 is installed in accordance with the approved drawing/plot plan/survey on file with'the County. certify the fence is: 1. Located within my property boundaries. 2. Not located within any preserve areas or easements. 3. A Maximum of 4 feet in height in any required front yard setback. 4. A Maximum of 6 feet in height on the side and/or rear of the property. 5. Not located within 50 feet of North Fork, Five Mile or Ten Mile Riverine, if my property was platted before 8/1/89 or not located within 75 feet if my property was platted after 8/1/89. 6. Outside clear sight triangle (fence shall be erected in such a way so that adequate sight distance of any vehicular or pedestrian access is maintained) 7. "Not used as a fence pool barrier (initial) Kl- Owner/Contractor Sign ture Date Print Name Cert. No. The foregoing giinstrument _was acknowledged before me this day of '20 B1Y��`� 1 6 Personally Known n Produced ID—"NO ry Public Type of ID Produced "FENCES USED AS POOL BARRIERS MUST BE INSPECTED BY THE COUNTY �.00Ry LASHAHNA INGRAM Notary Public-Stata of awith .•?My Comm.Expires Dec 20,2015 ?m♦ r w Commission 4 FF 177249 Banded through National Notary Assn. Planning&Development Services Department Building&'Code Regulations 2300 Virginia Avenue Fort Pierce,Florida 34982 (772)4624553 OWNER/BUILDER AFFIDAVIT DISCLOSURE STATEMENT F.S.459.103('n EXEMPTIONS State law requires construction to be done by licensed contractors. You have applied for a permit under an exemption to that law.'The exemption allows you,as the owner of your property,to act as your own contractor even though you do not have a license. You must provide direct, on-site supervision of the construction yourself. You. may build or improve farm outbuildings, a one-family or two-family residence for your use and occupancy. You may also build or improve a commercial building at a cost not exceeding $75,000.00 as long as it is for your own use or occupancy.You may not build or improve said structures for the purposes of selling or leasing that building. If you sell or lease a building you.have built or improved within one year after construction is complete, then a presumption is created that it was built or improved for sale or lease,which is a violation of this exemption. You may not hire an unlicensed person to act as your contractor or.to supervise people working on your building; it is your responsibility to make sure that people employed by you have licenses required by state law and by county or municipal licensing ordinances. You may not delegate the responsibility for supervising work to a licensed contractor who is not licensed to perform the work being done. Your construction must comply with all applicable laws,ordinances,building codes,and zoning regulations. Initial I understand that the building official and inspectors are not there to design or give advice on how to meet the minimum code. Initial — I understand that as an owner-builder that any contract disputes with sub-contractors and I must be handled in a civil court with the advice of an attorney. This department will not mitigate any contract disputes. Initial 6 9 I understand that if I compensate any person or company for work performed they are required.to be licensed in this jurisdiction. If for some reason they do not possess a-license,I may be responsible and liable for the cost of the license. Initial I understand that if any person that is unlicensed and uninsured gets injured on my construction prroject-, they may be entitled to workmen's compensation. I could be held.liable for all doctor,lawyer and related medical cost,which could include loss of wages during recovery from their injury. Initial To qualify for this exemption under this subsection,an owner must personally appear and sign the building permit'application and initial the above. I hereby acknowledge that I have read and understand the above disclosure statement and that I further understand that any violation of the terms of the owner/builder exemption shall be reported by the Building and Zoning Department to the Florida State Department of Professional Regulation. Signed and acknowledged on this dayofSopJ of 20�. • Owner/Builder Sign e STATE OF FLORID COUNTY OF The foregoin instrument wad acknowledged before me this day of 20n by who is personally known to me,or who has produced, as identification. tgnature of Notary U Type or Print Name of otary (Seal) Title:Notary Public Commission Number LASHAHNAINGRAM SLCPDSD Revised 05/15/2014 i Notary Public-State of Florida f ' My COMM.Expires Dec 20,2018 COt MISSlon#FF 177249 h0#1111rough National Notary Assn.` auJ� ILE11/1ER11'AL CONSTR+IJCI"I'ON LIEN LAW I`IU'�ORMATIUN: 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 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 Commencement. .STgnature of Ownerf Lessee/Contractor as Agent'for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF Lie`Q , COUNTY OF The forgoing instrument was acknowledged before me The forgoing in.strument was acknowledged before me this S day of _Na 20 1-1 by this day of . 20_ by (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary Public-St a of Florida ) (Signature of Notary Public-.State of Florida) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification x -' Type of Identification Produced �..���yP;%, LASHAHNA INSAW Produced a� Notary ublic-State at fFloridt Commission No. •`Myr{�Exj�fres Dec 20.2018 Commission No. (Seal) Comr11#FF 177249 41rwrµ 'r 8ondtd through National Notary Assn. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.