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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFOMUSTBE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �� r Permit Number: L U lJ s►> ° V Building Permit ApplicatioJAN Q 4 2019Planning and Development Services L—RECEIVED ucie 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: 10M NRROVE ; ENT Address: -5s d Z lVk ,-e Y-C-e- f�L- Legal Description: Property Tax ID#: 3 © Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: OF- 5k+s e oull-eky CQ` �TRUCTIO INFO +MATI®N: Additional work to be performed 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: 40 Cost of Construction: $ �� Utilities: —Sewer _Septic Building Height: OW ER/LE�S� EE: CU TR OR: Name -rto- 14yr La-Z Name: Address: Company: City: >C 'b `'� State:zs�L Address:- I Zip Code:.3Ct Z Fax: City: State: Phone No. 2 17 — C(/�l —l4 SS' Zip Code: x: E-Mail: Phone No Fill in fee simple Title Holder on next page(if different E-Mail NJ from the Owner listed above) State or County License If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. Planning&Development Services Department Building&Code Regulations o . 2300 Virginia Avenue RECEIVED Fort Pierce,Florida 34982 (772)462-1553 JAN 0 4 2019 OWNER/BUILDER AFFIDAVIT DISCLOSURE STATEMENT F.S.489.103(7)EXEMPTIONS ST. Lucie County, Permitting 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 l I understand that the building official and inspectors are not there to design or give advice on how tomeet the minimum code. Initial a t 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. C�7 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' 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 medical cost,which could include loss of wages during,recovery from their injury. Initial�2 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 Zoning Department to the Florida State Department of Professional Regulation. Signed and acknowledged on this 4—day of 6M�, of 20 Zb . OwnerBUl r Signature STATE OF FLO COUNTY OF �e-foregoin 'nstrument was ac owledged before me this . day of, I" 201q, by U who is pers nally known _ to me,or who has produced as identification. Signature of Notary Type or Print Name of Notary (Seal) Title:Notary Public Commission Number SLCPDSD Revised 05/15/2014 ��;srPu , tJ , KAREN S. NIELSEN ��\� State of Florida-Notary Public �. •= Commission #GG 207484 iV} Yi M Commission Expires y June 12, 2022 •