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HomeMy WebLinkAboutBuilding Permit Application (2)All APPLICABLE INFT BE COMPLETED FOR APPLICATION TO BE ACCEPTED O MU r / -Date: Permit Number: 6 1 I ' 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: PRC}ROSED INPROVEMENT LOCATION: Address: _( (lud 1 ON ti aiue- r 1 . Legal Description: Property Tax ID #: Site Plan Name: Project Name: Setbacks Front Back: Right Side Left Side: . Lot No. Block No. I i FeOcc R%pLA ngn o Ra1.0 e45I Ftzoal _ Co�!s� ►E� DF- 1 O (o 108 Pp1Ja�Ls o of S, 0-e— x R o rte. (=fly FRokf—i _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: $ �Jr`� r Utilities: —Sewer _Septic Building Height: OWNERIIRS RE: C©NTRACTOR: Name 04{RDL, Fi ep-tS o a Name: Ai A-) Company: Address: 0TAAJA 14UQ- City: PT, f i i�L�M�NT' L CC�}NS� a tJCfTI �N L1N L-now.AW 1•N� � RMTlO . 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 your Notice of Commencement. Signa Owner/ Lessee/Contractor Agent for Owner Signature Contractor/License Holder ure of as of STATE OF FLORIDASTATE OF FLORIDA COUNTY OF CSo� ClP COUNTY OF The for Ring instrument was ackn wledged before me The forgoing instrument was acknowledged before me this ay of 20I�` by this day of 20_ by C are � 1Ao a: Name of person making statement. Name of person making statement. Personally Known OR Produced Identification 'V/ Personally Known OR Produced Identification Type of IdentificQn Type of Identification Produced ,I JL— \1 �� Produced ignature of u ic-t�y�f��i�a) oNotary (Signature of Notary Public- State of Florida ) pry... Public - State of Florida Commissidd. o K _ Commission # FF 2(sm) 6. Commission No. (Seal) My Comm. Expires May 27, 201 %0F F �`� Bonded throw h National REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 8/2/17 BOARD OF COUNTY i i PLANNING & DEVELOPMENT SERVICES DEPARTMENT Building & Code Regulation Division i Residential Fence Affidavit of Compliance I, 1. (U oL. intending to be legally bound, hereby certify that work authorized by Permit Number 1711-0652 is installed in accordance with the approved drawing/plot plan/survey on file with the County. I 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 at any vehicular or pedestrian access is maintained) 7. "Not used as a fence pool barrier�f o)4 (initial) Owner/Contractor Signature Q-4P6L> Print Name la&h-7 Date Cert. No. The foregoing instrument was acknowledged before me thi�day of cc-) Q , 20D Notary Pu Personally Known odu end-lD,�_ Type of ID ProducedLy- 1 L- p ANGELA M HUFF � S";- PY i Lu4 111A VO�tol�AMI RS MUST BE INSPECTED BY THE COUNTY "tf ' n ssion " F 234730 o� My Comm. Expires May 27, 2018 ',, CF F "n ��� �! " " Banded through NationalNotary Assn' 0 Planning & Development Services Department COUNTYBuilding & Code Regulations • R I D A 2300 Virginia Avenue 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 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 apJicq);le laws, ordinances, building codes, and zoning regulations. Initial 0 � I understand that the building official and inspectors are not there to design or give advice on how to meet i the minimum code. Initial Z9 9 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. ff // Initial P9 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 Rg I understand that if any person that is unlicensed and uninsured gets injured on my construction project - they may be entitled to workmen's compensation. I could be held liable for all doctor, lawyer and related giedical cost, which could include loss of wages during recovery from their injury. Initial 7;� 9q_ To qualify for this exemption under this subsection, an owner must personally appear and sign the building permit application and initial the above. j 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 ')�$ day of N60,,11Ra2 of 20. OwnerYBuilder Signature STATE OF FLORIDA COUNTY OF The regoing in1truTent was acknowledged before me this day of L2,CA 20, by who is personally known to me , or who as 7od d � L— as identification. -Eke, F Signature o otary Type or Print ane of Notary (Seal) Title: .-N. _ bl' inmission Number ANGELA M HUFF P 'r°t 4` Notary Public - State of 'Florida , SLCP SA, e y -15/79a�mission # FF 234730 +; ; My Comm. Expires May 27, 2019 ��� Bonded through National Notary Assn. 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