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Home My WebLink AboutBuilding Permit Application ' All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: u Permit Number: _.:. .:RECEIVED._._`- - Building=Perrmit A_ pplicatid Planning and Development ST, Lucie County, Permitting 'Building and Code Regulation Dwision 2300 Virginia Avenue,Fort Pierce•FL'';34982 Phone:,(772)AEi2-1553-"Fax r(772)-462=1578° '-''' COfY1f1 erCial R251d2nt18I- P.ERMITAPPLICATION.FOR: ` , } Address: i n Legal Description:- - - r ,� T �� ' E Property Tax ID#: :.� Lot No. SitePlan`Name: i Block No. Project Name: - Setbacks" —;'Front. Back: Right Side: ; ' .e .4�- - .(` iii; d _ - : -:1° .s�• - -.._. - .__ .. _ _._._ --- r, s ' i, l Additional worK to.be pe_.Orme :un, ertt is permit,77ChecK all t at,app y:.,t.,:,.: ` _,Mechanical, •Gas Tank, ,, - ` .•Gas•Piping -Shutters,' " Windows/Doors _6✓E.lectric ; _ lumbing " _Sprinklers. _Generator, Roof Pitch Total Sq:'Ft of CoriA— ction: I Sq: Ft:of first Floor: - Cost of Construction:$ � t "Util'itie's•:` " 'Sewer` Septic Building Height: Na'rrie 4, - = Name: -: - �:�.is Addrennss: �i - i• -. . Company: City"t :� _State; Address::. Zip Code: Fax: - City: State: PFione No: Zipt.Code-- - Fax• _ E-Mail: ,, 5 ' ., BAWL# Phone No "� ;Fill in=fee simple Title Holder on next page(if different E=Mai l 'from th`e'Owner,l s#eii:_above) '''.. '._ :-- _State or County 'L'ice' If-value.of construction is 2500 or more,a RECORDED Notice of Commencement is required. - -DESIGNER/ENGINEER: :` Not Applicable MORTGAGtCOMPANY . .- Not Applicable- Name: ` Address: - ' Address:. - City State: - City State: Phone Zip. Phone: FEE SIMPLE-TITLE-HOLDER: /-Not Applicable - BONDING COMPANY:----Not Applicable Name: - - Name: Add-cess Address: City: City: .- - '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 make s-1 no,representation that is granting a permit will authorize"th'e""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..Flease 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'plaris,,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-- j before the fi st inspection. If you intend to obtain financing,consult with lender or an.attorney before cornmenci ork or"rec diri our Notice of Commencement. "Sigmatu're.o Owner/Lessee ontractor'as Agent for Owner Signature of Contractor/License Holder i STATE OF FLORI - -STATE OF FLORIDA - COUNTY-OFCOUNTY OF The fo ging instrul a t-w acknowledge efore-me The forgoing.instrument was-acknowledged before me this "day of 20by thisday of .20_"by` (Name_of perso acknowledging-),_ _ (Name of person acknowledging) (Signature-o No ary Rubltc=Siateof orida) (Signature of Notary.Public-State of Florida) ,Personally Known OR_Produced'ldentification Personally Known OR Produced Identification' Type of ldentjftcatio Type of Identification - Produced ,P odbced- spYP�o,, . KAREN S. IVIELSE .Commission,No. . . - ` ��-;Jfieal�f Florida-Notary Pu mission No. (Seal), Commission'#GG 2071 4 ,��oF��oPP,' My Commission Expire z. . : i., 'SEA .i REVIEWS = FRONT` ZONING SUPERVISOR ''PLANS ' VEGETATION" " 'SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED s DATE. w- MEPlanning&Development Services Departme t RECEIVED Building&Code Regulations 2300 Virginia Avenue 4.2��8._... Fort Pierce,Florida 34982 SEP o (772)462-1553 ST.LuCle County, PQrTiiting OWNERBUILDER 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 a licable laws,ordinances,building codes,and zoning regulations. Initial a� I understand that the building official and inspectors are not there to design or give advice on how to 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 liable o the cost of the license. Initial 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 decal cost,which could-include loss of wages during recovery from their injury. - InitialWei 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 statement and that I further understand that any violation of the terms of the owner/builder exemp . shall be reported by the Building and Z rng Departent to he Florida St Department of Professional R gul •i Sign d and acknowledged on this day of of 20 4 . 1000 OwnerBuil a Signature STATE OF FLO A COUNTY OF Thfore ristrume was acknowledged before me this day of ,.20 , by who is personally known to me,or who has produced as identification. AA Signature of Notary Type or Print Name of Notary (Seal) Title:Notary Public Commission Number SLCPDSD Revised 05/15/2014 ".`"Y P i j n KAREN S. N I E L S E N .•oA :° State of Florida-(Votary Public _• *= Commission #GG 207484 My Commission Expires June 12, 2022