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Home My WebLink AboutBuilding Permit Application AII,APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 041/05/(QOM • Permit Number: i &-tI – D11-7 F L O R II Di ,At �� Building Permit Application o Planning and Development Services !'ttj 5418 Building and Code Regulation Division S�" � Qepa 2300 Virginia Avenue,Fort Pierce FL 34982 �`'' 'e4t Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential . PERMIT APPLICATION FOR: g . ., maaP u'^ ":� £t`.,"rS ..: y W+'r a,'kG b ey'T., r ti P � ,,,'" '.' _d e PROPOSED IN,;PROVEMENT LOCATION , .� .4 .,. s. G d .1r,v . , Address: 550 3 D e.e R (Z w4 D (k FORT P i e r e. FL 3 419 51 Legal Description: Property Tax ID#: j J,l ($ C-�-% – Cy--.�1-t �:� �-�j Lot No. Site Plan Name: Block No. ' Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK ;.- i-5s4 1 '�'k „;n pa '_ ' "` .t f-qtk e `' 1", Ma'-1' Re P(Ace_ T o 5 h eels o f fc7N6 T . d,g,oe g D RA's4/,/4ov{k- NAils ay cew-'PL Sit, oo, (eA Tfr p --e„ FEC-( CO �STaRJCT , ®U ®RN4TIy N 3} f k 4 `.: 9ire� n "sa . l ti t t .N1N :: f` . W: r , , 72i,; x. ;11,1; ,:'!:34.i,.: Additional work to be performed under this permit–check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutter Windows/Doors' c:: Electric —Plumbing _Sprinklers _Gen rte; _Roof Pit • Total Sq. Ft of Construction: , i:�"2.f; `-` �s Q �� Sq. Ft. of First F or�,� Cost of Construction: $ (� • Utilities: _Sewer ` 'ic Building Height: OWNER/LESSEE ' 4 " ° �t'';' ' ,3CONTRAiS as A a�x� �x a ,.. .... hFs ,,.._ �..�.'ma' "�- � �'"� .. _.> ' "2� i �i.D . st u�� ,.. ,. ,$� � i�:7�. � "e.hff. �>u '❑ i.._ Name 13K1 11-0m A• fv1A-D Do x Name: :,r1 le n, , qt ai ,a Address: OA ,;;., I,`rC.',.-• ,j�o 3 p� �VO�� Company: ,.liAlmr.ro: City: FoAl P 1 eAce State:FL Address: 11,188:ji../ 64444e",, ne„ '`;;' Zip Code: 31.195” I Fax: City: - State: Phone No. —7-72-777- .03 57 Zip Code: Fax: E-Mail: RS , 13/1-N SG 1/9i L . Cat-)Phone No Fill in fee simple Title Holder on next page (if different E-Mail , from the Owner listed above) State or County License If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. ' SUPOCErkkiTAI,ONtl-kijrC idil LIEN LAW� OkiVIAttONo �'' ' , , � al. ' ",.. DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: • . . . .... .. .. Address: Address: City: State: City: State: Zip: Phone Zip: Phone: r. FEE SIMPLE TITLEHOLDER: 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. 000010:11.41P 72:2aie,*"Si: ature . Owner/Lessee/Contractor asAgrier Signature of Contractor/License Holder . STATEOF FLCOUNTY OF ORIDA ST LUGi e C D(, y COUNTY OF FLORIDA • The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before.me this grin day of ft PA,'G. ,20 IQ by this day of , 20 by BRi. ON A. MA-J()UA7 .. . ., Nam: o ( Pgrson acknovi(I'eiigi,,gr)ENGRAM (Name of person acknowledging) a.Th,Y--. .:, c $ ry .:.� - Stale01IRM • i_��".• My Comm L,pues Dec 2Q ;O111 —t��w Corm !,,..;,,),i # FF 177249 (Sign. • '19ota"' 'utill-'_,5tateorioli ..,..,,1 (Signature of Notary Public-,State of Florida ) Person. ly Known A _ J 4 ' c?•d ce ..,-.,, . a 'o . Personally Known OR Produced Identification `',•' ''"'""" Type of Identification Type o Identific. i."��,,,, yp Product: �; ,,r as ky, LASHAHNAI Produced - - -....:., -StiM a Fltlrlda t • ii. ) My Comm.Expires Dec Si,2010 Commission No.V.. 4. pleptlslh(6eai3177249Commission No. ' .' '(Seal) F ''nit= s 8ont1M NtttlpiINPUY AssO. F __ . REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION '. SEA TURTLE- MANGROVE COUNTER REVIEW REVIEW REVIEW ,REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ley. 7/2014 STILI U CI E Planning&Development Services Department CO U NT)6,,,-- , -.=- Building&•Code Regulations - . . ._ .._ .. ¢F,,.,:-,by :r 4-,,b,:_4:,,,•,.„_. . ._2300 Virginia Avenue • Fort Pierce,Florida 34982 W44. -`•-I"'t t AI I (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 ap li able 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 01 • 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 B ill 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 e,f'1 I unstand that if any person that is unlicense anduninsured gets injured on my construction project- they may be titled to workmen's compensation. Fto., .be held liable:for all doctor, lawyer and relate medical cost,which c „A include loss.of wages during recovery' oar their injury. Initial /1r1 To qualify for this exemption under this s4Nron,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 abovedisclosure statement and that I further understand that any violation of the terms of the owner/builder exemption nail be reported by the Building and Zoning Department to the Florida State Department of.Professional Regulation. Signed and acknowledged on this day of APR'L of 20 /8 . i) _. r uilder rgn ture STATE OF FLORIDA ' COUNTY OF 57' L tic;e n The foregs ing instrument was acknowledged before me this day of Ar/ (. 20 / g, Mokaidec who is personally known to me,or who has - p '7 : : A as identification. aR c's Notary Public-State o1 Florida C�� : .1114y— Comm.Expires Dec 20,201; . r• 4L • sign,' . $1(gtr' . � j.I mmfs5ion FF 177249 pe o rrnt Name of No . (Seal) Titlexi*Iotar a%i`V throe ph National Notary As ' , ommission Number SLCPDSD Revised 05/15/2014