HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:izI
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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 X
PERMIT APPLICATION FOR:
J
PRQP0SED INPROVEMENT LQCATIt3N �
Address: �oo5 `V �' r.. �i iy O p
l
Legal Description:
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Property Tax lD#: 3� 01 •�n C�Q • o saS ' �1��� Lot No.
Site Plan Name: ! Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side: "
DETAILED DESCRIPTIQN aE 1lVQRK• i; , w4
t g o%VL 'on
L.12.
CaSTRUCTICIN INFORNIATI'ON °s
u
.
Additionalwork to be'pertorme under this permit—check all2that 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: $ 10 C)0 Utilities: _Sewer _Septic Building Height:
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QINNER/LESSEE, R Ct3NTRA
CTQR; ra
Name06 i G Name:
Address: (O D iM Company: i
City: I Rr U_ State: Address:-''-
Zip
ddress:-'•-Zip Code: �-t Ci g Fax: City: State:
Phone No. a- Zip Code: Fax:
E-Mail: S �^C1 l, Phone No
Fill in fee simple Title Hold on next page(if different E-Mail
from the Owner listed above) State or County License
EvaluJe of construction is 2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW IN
FORMATION.
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
be,or-e-C irst inspection. If you intend to obtain financing, consult with lender or an attorney before
r,cimmenciryg work or recording our Notice of Commencement.
S tGre of wner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 5-�'k-1-� COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this "1 day of Z-%,- ►
c. ,20_ by this a_day of )Q_c, _ , 20 )-1 by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State bf Florida) (Signature of Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced. Produced
Commission No. (Seal) `' Commission No. (Seal)
--- "� ASiat�R°F�otlda
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i� ' •,�pa��uB`� Notac �"EXp1t's UFy 7"f2a9
REVIEWS FRONT^' a0 R1 ss}on#SSU gRN PI-5 PLANS VEGETATION SEA TURTLE MANGROVE
CO '[�TxR` RE�f�P ou9h''� �2EVI'EU1% REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
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Planning&Development Services Department
Building&Code Regulations
° 2300 Virginia Avenue
Fort Pierce,Florida 34482
(772)462-1553
OWNER/BUILDER AFFIDAVIT DISCLOSURE STATEMENT
F.S.489.103(7)EXEMPTIONS
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State law requires construction to be done by licensed contractors. You have applied fora 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 isl complete, then a
presumption is created that it was built or improved for sale or lease,which is aiviolatiori 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 lawl and by county or
municipal licensing ordinances. You may not delegate the responsibility ford supervising work licensed
contractor who is not licensed to perform the work being done. Your construction must comply w. all pplicable
laws,ordinances,building codes,and zoning regulations. :i I I i ial
I understand that the building official and inspectors are not there to design or give advice on w meet
the minimum code. Initial
I understand that as an owner-builder that any contract disputes with sub contractors and I mus andled
in a civil court with the advice of an attorney. This department will not mitigate any contract disputes.
p
i
Initia
I understand that if I compensate any person or company for work performed"they are re r to be
Iicensed in this jurisdiction. If for some reason they do not possess a Iicense,I may be responsible and I abI r the
cost of the license. Initial
i
I understand that if any person that is unlicensed and uninsured gets injured on my constructs oject-
they may be entitled to workmen's compensation. I could be held liable for all doctor, lawyer and rel ed edical
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 statementiand that I further
understand that any violation of the terms of the owner/builder a shall a reported by the Building and.
Zoning Department to tie Florida State Department of Professi al Regula on. ;;Si ned and acknowledged on this
7 day of_ a�lq of 20 .
074 wnerBuild Signature
STATE OF FLORIDA
COUNTY OF S a
The foregoing instrument was a^cknowledged before me this � day of I ,20 }`1 ,
by � -��. Y�{�5( who is personally known I to me,or who has
produced
95L QA 1 as identification.
Signature of Notary Type or Print Name ofNotary (Seal)
Title;Notary Public Commission Number
SLCPDSD Revised 05/15/2014
11 ,�.„ LASHAHNA INGRAM
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Notary Public-State of Florida
l n My Comm.Expires Dec 20,2018
commission#FF 177249
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'rrOF`''� '„ Bonded through National Notary Assn.
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LOT 26
BLOCK 66 ;� 1
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NO
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125.00 P IRON ROD. WM
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No I;D. 30.0
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SHED ON ;< r •. e. j',., d v
GROUND •' I_• •41.8 •I'
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FOUND 1/2" o N90'00'00"E 125.00'(P) FOUND, 1/2" 1 30.0
IRON ROD IRON ROD
NO I.D. NO W
LOT 28
BLOCK 66
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FOUND 5/8"
SUOV
EY NOTES IRON ROD
F.H.AREQLTHUBIENTS DIST.• —CONCRETE DRIVE CROSSING OVER PROPERTY N0. LD.
SEPTIC TO HOUSE 8.4± LINE ON EASTERLY SIDE OF LOT. 6 BLOCK
SEPTIC TO SOUTH PROP.LINE 26.6"± —THERE ARE FENCES NEAR THE REAR AND I CORNER
SEPTIC TO EAST PROP.UNE 25.4'± SIDES OF THE PROPERTY.
—PROPERTY SUPPLIED BY CITY WATER.
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PAGE 2 OF 2 PAGES
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s`oh FL OATE R D P oa a SGNATUREANDAUTHENTICA DEELECTR CA TED ELECTRONIC SERVING ALL FLORIDA COUNTIES
S U R V E i OR A RASED EMBOSSED SEAL AND SIGNATURE. i
Digitaeysfgned by 6250j14.MILITARY TRAIL]SUITE 102
Clyde O.o d-o --N-,. WEST PALM BEACH,FL 33407
McNeal,C.=Us PHONE,(561)640 4800
McNeal- Date.,2014.02.1clyde2 FACSIMILE:(561)640-0576
(SIGNED) Iz11:ts osn°' STATEWIDE PHONE (800)226-4807
CLYDEO.McNEAL,PROFESSIONAL SURVEYORANDMAPPER#2883 STATEWIDE FACSIMILE (800)741-0576
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FLA Manufactured Bv'dJ q Program
'I NO Nonh Morme Sheet
' �E�iS�C1e5�i�:L- � +' suLes�
Professi nal !`'
taMhassee,Ptor�da 3239gf17T2
tt Phor�;-85D4871821• Fax.85D.4t48436
Ken Lawson,Secretary j RickSco%Govemor
-September 23,2016
Alex Martens
Superior Sheds,Inc.
2323 S.Volusla Ave
Orange City,FL 32763
RE: Manufacturer Certification,ID MFT-113;Expiration Date:September 22,2019 1 .
I
Dear Alex Martens
I
It is my pleasure to inform you that Superior Sheds,Inc.,located at 2323 S.Voluaia Ave,Orange
w - City,FL 32763,has been approved under the Manufactured Buildings Pmgram,as provided for
under Chapter 553,Part I, Florida Statutes,to manufacture Storage Sheds,Manufactured
Buildings for installation In Florida.
Construction or modification on a manufactured building cannot begin until the Third Party
Agency has approved the plans iii accordance with the current Florida Building Code. Your Third
Party Agency is a contractor for the Department and has statutory authority and responsibilities
that must be met to maintain approved status.You may expect and demand quality plans
review and inspections.
Each Code change will make your plans obsolete until they have been reviewed,approved and
indicated[on the cover page of the plans]for compliance with the Code by your Third Party
Agency for plans review.Please ensure that your plans are in compliance and are properly
posted on our website.All site-related installafign issues are subject to the local authority
having jurisdiction.
' I
The Department's contractor will make unannounced monitoring visits atleast once each year.
You must grant complete access to your manufacturing facility and records to remain In
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compliance with the rules and regulations of this program.
Your certification is approved for three years from this date.You will receive a renewal notice by
Email generated by the BCIS(ww.f idabuilding.orq)for online renewal.If you have questions
ons
you may contact Robert Lorenzo at 850-717-1835 or our FAX at 850-414-8436.
I '
Please visit our website at www.floridabuliding-orq to see valuable information on the Florida
Manufactured Buildings Program.A copy of this tetter must accompany applications for local
building permits.
Sincerely,
Robert Lorenzo
Manufactured Buildings Program
cc:Professional Service Industries
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