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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date:_�Q- '�� Permit Number: RECEIVED _ Building Permit Applicati n Planning and Development Services OCT 5 201$ Building and Code Regulation Division 5T, Lucie County, Permitting 2300 Virginia Avenue,Fort Pierce FL 34982. -- Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: U - Af ROP�SED tNPROVEME T L© ATION: Address: eC74 Tay Garoltns L n 74 /Force rL .)MIR y5' Legal Description: Tay Al R CrcG 84K � �o�S /,fly Property Tax ID#: 0//311 Lot No. Site Plan Name: &ye- Grcu�yf oo� Block No. Project Name: to Cover 4eow / 10oa/ Setbacks Front /00 Back: A Right Side: �-3 Left Side: h5 TAI� ED DE�5�• I PTIQN OF WORK: yrs �� ��oY� ✓oa Dov no /-6.n (f dor an-'!rE 9& CO` STRUCTI0. INFOR+MATIfJN: Additional work to be pertormed under this permit-check all that 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:$ 500 , GO Utilities: _Sewer _Septic Building Height: OWNER AmosSEE. CONTRA R: Name TeAncy Reve,�s �_ �; ° Name:'fbr_!bq� 4,r Address: 9x'70 7, c_,y ny •^- j;. auk':; .ra,;..nas,�u �•u.,Itn'' ,k City: �j�. /�'srca State:.FG.•k• Address:.] :��., �•.�..,h..: Zip Code: 3"19415 Fax: City: State: Phone No. 77.2Zip Code: Fax: E-Mail: ,cson Arvel5 Phone No Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State or County License lEvalue of construction is 2500 or more,a RECORDED Notice of Commencement is required. 0011PRIPIMIRME AL CONSTRs ION LIEN LAW Ifs `ORMATt@N: 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 thepermit 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 recordin ` our Notice of Commencement. Ature of Owner/Lessee/Con ractor as Agent for.Owner -Signature of Contractor/License Holder STA OF FLORIDA STATE OF FLORIDA NTY OF COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this 4 day of �G�a�p er 20IX by this day of 20_ by Jemf��k�w LoAccQ (Name of person acknowledging) (Name of person acknowledging) �,m 0(,// 1(/tm — (Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida) Personally Known ✓ OR Produced Identification Personally Known OR Produced Identification Type of Identification o dentification Produced. No"Public Stbuc _ ;F ,IMnNer Frm��la Commission No.LtIG'Io�S(�SCo J G: on No. (Seal,) . REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE - MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Re—v.7/2014 f ., Planning&Development Services Department ® Building&Code Regulations RECEIVED o 2300 Virginia Avenue Fort Pierce,Florida 34982 r (772)462-1553 OCT 0 5 2018 OWNER/BUILDER AFFIDAVIT DISCLOSURE STATEMENT ST. Lucie County, 1`11#Mitting 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 applicable, laws,ordinances,building codes,and zoning regulations. Initial I understand that the building official and inspectors are not there to design or give advice onh w oieet the minimum code. Initia . 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 lid e f he cost of the license. Initial Tr understand that if any person that is unlicensed and uninsured gets injured on my construction �1e t- they may be entitled to workmen's compensation. I could be held liable for all doctor, lawyer and relat e'd'r I 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 statement and that I further understand that any violation of the terms of the owner/builder exemption shall be reported by the.Building.and Ztng Dep�ment to the Florida State Department of Professional Regulation. Signed and acknowledged on this day of l&(),)�of 20 . erBuilder Signature STATE OF FLO D COUNTY OF The oregoing mstrumegt was a owledged before me this 5 day of t ,20JE by 1 vr1l. . who is personally known to me,or who has produced as identification. cs� Signature of No w: Type or Print Name of,Notary (Seal) Title:Notary Public Commission Number KAREN S. NIELSEN o`"R B��,State of Florida-Notary Public SLCPDSD Revised 05/15/2014 �_ .= Commission # GG 207484 � My Commission Expires OFF`°��� June 12, 2022 REC�I�eD ST,Wcie County r?erm;t�in9 I� t ` r M Q JZ � w 4k-- to L4 W