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Home My WebLink AboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: ' O ' � - RECEIVED F - - - • Building Permit Applicatio OCT o 5 2018 Planning and Development Services ST. Lucie County, Permitting Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: F,.ekL -roe PRQP®SEDINPROVEM1ENT OCA ION' Address: gid 70 MY 1!;Cyaleas LA T'T /:`crcc tee ?elge S Legal Description: Tr-y 6 ,e6leg f7' do;eeee BL/t y Lops Property Tax ID#: 00a 000 `�C Lot No. /7 Site Plan Name: GA C t= Block No. Project Name: P(jnGti Setbacks Front Back: Right Side: Left Side: DETA LED � E� CR�IPTION OF ORK nn �+- /7 r✓I1 G70Wr] .SP'e /'D r 9L /dr r✓CW'Ca. n0� Tr �v4 4,r 4orn e C�N5TRUCTI •N INFORM TION. Additional wor to be performed under this permit-check_ a.11 that app-;y ,, , ;;«, i. � >�- :r i':Sr.t'>s`•}i'�,=SII" Mechanical _Gas Tank —Gas Piping ': Sl otters Wi indows/Doors — �5+�[:i„S{St�M��i;�,�hrrs.,r'tci�`�af:�f"`•a'�r:-'`k•"•t+�y°R-'.T'. _Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: 0 1 Utilities: —Sewer _Septic Building Height: 0 NER/L SSE CONTR CTOR: Name rnAr, 1?c✓G Zs Name: Address: 9&1'7a Toy Company: City: State: Address: Zip Code: 3y9y5 Fax: City: State: Phone No. 77.�- a,24/- 93P93 Zip Code: Fax: E-Mail: j&con G/'G✓G/,f co .caws 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. 5w1P1L1MENTA CONSTR+UTI�N LI'!EN l�1W IN '® tMATION: 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 our Notice of Commencement. �gn ure of Owner/Lessee/Contractora.s Agent for Owner Signature of Contractor/License Holder SI OF TATE OF FLORIDA. COUNTY OF FLORIDA.5V W6 COUNTY OF The for ping instrument was acknowledged before me The forgoing instrument was acknowledged before me this��day of OC this day of 20_ by in��\/ o✓ =Fanta" (Name of person acknoMy CMMMft 00 25MI (Name of person acknowledging) (Signature of Not Pdbblic-State of Florida} (Signature of Notary Public-State of Florida} Personally Known v OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced ��77 Produced Commission No.61C- X6-G512 1 (Seal) Commission No..,. (Seal} REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.7/2014 Planning&Development Services Department f Building&Code Regulations RECEIVED 2300 Virginia Avenue Fort Pierce,Florida 34982 r (792)462-1553 O G Q et 2018 OWNER/BUILDER AFFIDAVIT DISCLOSURE STATEMENT �T, Lucie County, MI'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 Iaw. 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 Iicensed to perform the work being done. Your construction must comply with all aQ�IicabIe. laws,ordinances,building codes,and zoning regulations. Initial -ic:� I understand that the building official and inspectors are not there to design or give advice on h o met the minimum code. Initis jam-+ . 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 Iicensed in this jurisdiction. If for some reason they do not possess a license,11 maybe responsible and Iia ;e f e cost of the license. Initial`( I understand that if any person that is unlicensed and uninsured gets injured on my construction rgje t- they may be entitled to workmen's compensation. I could be held liable for all doctor,lawyer and relat efi 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 haveread 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 g Depent to the Florida State Department of Professional Regulation. Signed and acknowledged on this dayoQ, 2of20_1%_. er/Builder Signature STATE OF FLO D COUNTY OF The foregoing instruniegt was aowledged before me this J day of ,20 by 1 V who is personally known to me,or who has produced as identification. cr---y Signature of No Type or Print Name of,Notary (Seal) Title;Notary Public Commission Number -.. AR `.11YAvrfj� KEN S. NIELSEN SLCPDSD Revised 05/15!2014 '=& 'y- State of Florida-Notary Public s• Commission#GG 207484 ,,� oa°;Z My Commission Expires ''nr°,;;;r, June 12, 2022 RECEIVED OCT 0'5 2018 T, Lucie county, Permitting ' .��MF b OL r 1 ;M Y iG /3Z' 1 _ , '