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Home My WebLink AboutBuilding Permit Application (2) All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 011051 a0/a Permit Number: 1 — bl 1�-7 l C i R Ste; F L O R. 1 1? .FY, .. Plannin and Development Building Permit Application Peik qpR oes- 9 P 4f Building and Code Regulation Division ��"" !��Q,o3 2300 Virginia Avenue, Fort Pierce FL 34982 �bneh. Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential . PERMIT APPLICATION FOR: _ .TOATIO -, ~ f �, ,-,.PROPOSED ROVnd1 Ldw*: .a174- .matv un�, , lx ..ano-4.&,f.., - ;. ! kswatts Address: 5503 c efR RLQ PR FORT Helve FL 3L-I95 ) Legal Description: Property Tax.ID if: i "�< L$ 1_ X41"moi l� `3 Lot No. ' Site Plan Name: Block No. • Project Name: . Setbacks Front Back: �u�y� Right Side: Left Side: C� A�-' 1' ' • ' S`"'8 A4r € 'r laf-�s' °i �C`+�ti k' i S" as a3} ''' 34s r " "' .--aw;„` '� qM r ®ETTAILE® ®E�SLORI,PTI"ON OF WORK ;, Q , i - 4gYz � m �. Re PLA-Cc :. 0 5 h e�,7s O F Rc7 N6 b T.1- 11 (bd(1-90 se D r •' Gsh /& JVArLS ODS, cep,"re L.: SIM -OKI <p.--e F L ,. E CONSTRW TION IN�FORNIATION �a.w7� .4.i, wm .:. ',- : 7 � . ,,,°� : ,� # ...'k'qua.x` . M." . ,�>�4a,a $ 'r . ' rn .�'�- ' ��-�.rh s,... r ': . ,t.' a.,l� hr �. '.-Wr;s. ,,.,,,. .v;„cv Additional work to be performed under this permit—check all that apply: 1 _Mechanical _Gas Tank _Gas Piping _Shutter Windows/Doors '.., Electric _Plumbing _Sprinklers • _Gen rte;. _Roof Pit, Total Sq. Ft of Construction: 6/ /fi`4' `� SQ FT' Sq. Ft. of First F orc,=__ � s Cost of Construction:$ 8 d 00 • Utilities: _Sewer _• ' ` :ic 'Building Height: OWNER/LE.�SSEE .. .;x; : . - . ... CONTRA T .,';',ii;;;-- ",7-i,-.-A4'...{` , any N .�: Name BK17rOm A. Mil-D 0 (J X Name: • .p ail s: : ��O 3 peel\ Auk/ DA Company:., •.` ,ti`A�.rnmoa Vt,: i. : Address: ;lair,;_tr '.- City: f O 7' P r eAce State: Address:. ;.r '4'''....`f."'..!:,..:::.:..,...;2:!.'1. , Zip Code: 3 c/4 5 I Fax: City: - State: Phone No. —712-777- 0357 Zip Code: Fax: PS E-Mail: ` S/I SLAY + (3/h @WI 9i c . CC/L)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. St °PLEmtNTALcoNs kod ®Nli NiNFk-mAtrow ' `cif` .i • : s 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. !� �/_ _ / Si 'ature Owner/Lessee/Contractor as Age o wrier Signature of Contractor/License HolderSTATE OF COUNTY OF FLORIDA STATE OF ST LUGS e C OUl1 COUNTY OF FLORIDA The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before.me this S'TT, day of ft PA,'L. , 20 N. by this day of ,20 by BK( B A. MA-DQ U?( Nam o ( .P, rs.ori acknowledgOA�NGRAM JJ (Name of person acknowledging) .4PRY rv, ' 1 �O*' \ ' f`.�, :.i!y i,r - St Ile O�f l$ / • u, ,r = C:o 'n• E`;'ue c .P191s �� ;: My�onun :ti; EF De177242Q0 (Sign— '. '1Vota R 'ubli State'behl .,.,.! (Signature of Notary Public;State of Florida) Person. ly Known A ; I e• fr,dce' -:•"=-'Ara 'o Personally Known OR Produced Identification Type o' Identific,r.`c LASHAHNA I Type of Identification Produc_: ` .,�',�'=•� _ . .state*,Florida Produced i, .� My OM.Expires Dec 211,20111 II Commission No.' aa, oMmIMMlDeaf3 177249 Commission No. (Seal) ''''8,„ .‘r•' Bonded NlttllM*WY Assn, REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE- MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW ' REVIEW DATE RECEIVED DATE COMPLETED 3ev. 7/2014 I. S T L C1 C I E Planning&Development Services Department COLINTY-,,,,.:.‘f Building&Code Regulations - . ..... '2300 Virginia Avenue „",w FVC« ;t° � 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 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 bM • 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. Q M Initial B/' 1 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 13/ti I unistand that if any person that is unlicens- • and uninsured gets injured on my construction project- they may be itled to workmen's compensation. F'co. i,be held liable for all doctor,lawyer and related,medical cost,which c include loss.of wages duringrecovery'i om their injury. Initial M (t g 0,. . j D • To qualify for this exemption under this s. ,1 -I on,an owner must personally appear and sign the building permit application and initial the above. • .t, 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 exewption §Iiall be reported by the Building and Zoning Department to the Florida State Department of.Professional Regulation. Signed and acknowledged on this 57h day of PR'L- of 20 le . i) . - r uilder ign ture STATE OF FLORIDA COUNTY OF 6—r LQ -i(2- The fore:•ing instrument was acknowledged before me this 57 day of AWL'(. ,20 / g, .`,• ,_ _.`e....;t . dt �l/laal lc who is personally known to me,or who has ' " ' l- as identification. p odo zy. Ll(1tRAIM r• I': Notary Public-State 01 Florida y -• ,*•" COMM. '�_1L• M -cN„ i171i' � s'MY ttt.Expires Dec 20,201: - �� Sighi,,, .. � I .. t. 'amnesiac#FF 177249 ' pe o`'rint Name of Not. 1 (Seal) Titlex Sia ry..Pu`� through National Nary As • ,' ommission Number i SLCPDSD Revised 05/15/2014 I