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Home My WebLink AboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: t� Wr} 4 ! Building Permit Application 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 PERMIT APPLICATION FOR: PROPOSED IN'PROVEMENT LC}CATIUN Address: to r'1 ?t"� Qf�y_ Legal Description: �y Irl 00(_11C 101 OA IPlf'cg1 Pirve.- (fStt \AQ_5 0,1f FEigh�- Property Tax ID#: > Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTIC►N a VIlCIRK CQNSTRQCTION INFORMATION Additional wor to be pertormed 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: Sq. Ft. of First Floor: Cost of Construction:$ Utilities: —Sewer _Septic Building Height: C►VtfNER%LESSEE = CTO CONTRAR.. v _ �., A. Name Chr'c`st-almj- Sewe'�,— Name: Address: —'_(dc� P"1M I-)r"VQ_' Company: City: �,rPr er�z. State: Address: Zip Code: K R.)�_ Fax: City: State: Phone No. 511 - �17 cl - o S Go Zip Code: Fax: E-Mail: _ C��iS See k�0002 G'lC', I - c'Jr) Phone No Fill in fee simple Title Holder on next page( if different E-Mail from the Owner listed above) St or County License JEvalue of construction is 2500 or more,a RECORDED Notice o v6m mencement is required. SUPPLEMENTAL CQNSTRl1CTION, IEN,'4A INFGRMATION Fu DESIGNER/ENGINEER:/ Not Applicable— pp 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. L- Signatu Owner/L ssee/Contractor as Agent for Owner. Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF ��_kc COUNTY OF The forgoing instrurignt was acknowledge before me The forgoing instrument was acknowledged before me this F---U of 20��y this day of 20_ by IIS (Name of person acknowl dging) (Name of person acknowledging) (Signature of N tary Public-State oY Florida) k (Signature of Notary Public-State of Florida) ersonall Known OR Produced Identification Personally Known OR Produced Identification ype of Identification' Type of Identification Produced Produced 6 J') ' Commission No. . :'2 �I: NotaryoHUFF State Commission No. (Seal) NAY a Q Commission#FF °f r(orlda =,,9� o,: 234730 ya Bonded through Na i WE aY 7,2019 f/' REVIEWS FRO I�ttlxtf °' �'`1316,11 PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW 1"EVr(~' REVIEW ' REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 7/2014 W,IC111 Planning&Development Services Department COUNTY Building&Code Regulations s '2300 Viigiriia Avenue I , Fort Pierce,Florida 34982 (772)462-1553 OWNER/BUILDER AFFIDAVIT DISCLOSURE STATEMENT F.S.489.103(7)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 longus 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 a c 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 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 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 liablf the cost of the license. Initial I understand that if any person that is unlicensed and uninsured gets injured on my const ructio project- they may be entitled to workmen's compensation. I could be held liable for all doctor, lawyer and related dical 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 th uilding 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 ownerlbuilder exemption shall be reported by the Building and Zoning Department-to the Florida State Department of Professional Regulation. Signed and acknowledged on this day of � of 20 1�. O gnature STATE OF FLORIDA COUNTY OF �.�V•— QQ'�� The fore ing instrum nt was acknowle eal befor me this�ay of Y.JC� 20�, by \�S m o is personally known to me,or who has produced `- as identification. C�)1�, Signature of N tary Type or PQ Name of=l�t (Seal) Title:No Public Commission Number o"'JP''�, ANGELA M HUFF Q °=f Notary Public-State of Florida * = SLCPDSD Revised 05/15/2014 ''�" � •e: Commission#FF 234730 y' 9�FOF My Comm.Expires May 27,2019 . "'F Bonded through National Notary Assn. J�= Utility Box Easement. r ®_ I 8. The accuracy of this survey is premised on the R.O..11j�y. = Right o 'Way expected use of the survey. The expected use / purpose of this survey is mortgage financing. Accuracy = 1 foot in 7,600 feet or better. 9. Additions or Deletions to this survey map by other than the signing surveyor is prohibited Without Written consent. LO 36 BLOCK 67 I ERT CORNER R 04 ' ' it N 900000 •- :1 r 12 . 0' FD M FENCE'ON LI E 18.60'CM 36.30' I ® 20.20 C C Ll. 20.00' CONI C14CAR DRIVE Op Q o PORT I O W LO C. . Z g g 20.00' a ll i O z o o N I o S 30.38' o a l wO N c .00 p NI E w w COVEREE 24.00 "�� OCL „. O O 400 S 2 F. `�'- O O - Z 6 18.36' _ A 36.44' N M v�•1 I ��jnlO•.O� FD N90°00'00"E 100.00' Fo �A CAO BASIN i 80' R.O.W. - 40' ASPHA i ROAD Easy Street FD NAIL 6109 Palm Drive Certified to: Christopher M. JeWett I' Atlantic Land Design GateWoy Mortgage Group LLC g First International Title, Inc. 16 of the Treasure Coast, LB7468 First American Title Insurance Company 764 NE Jensen Beach Blvd. Jensen Beach, FL 349 1 hereby certify that the survey sho*n hereon is true and correct C Mailing Address: and is based on actual measeurements taken in the field. This P.O. Box 1421 Jensen Beach, FL 3495 survey meets the Minimum Technical Standards of Chapter 6J-17 Florida administrative code. )I ceal 2 ALD5543@grhail.com (772)398-4290 oe0.�'P'o^rE James A. = Digitally=Jam ed by siroJrames A.Cesiro antl PSM 5543 REVISIONS �.DN:cn=James A.CeslroJr.,o=Atlantic Land Design,ou, change lenderCesiro Jr. Date;2017D.03221930;17.04'OOUS �F sTArC OF NOT VALID WITHOUT AN AUTHENTICATED ELECTRONIC g E FCOIt a LAST FIELD DATE:1 1./30/1 6 SIGNATURE AND AUTHENTICATED ELECTRONIC SEAL REO SURVEy0 - I