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Home My WebLink AboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1 0 Date: Permit Number. I 9 RECEIVED � _ y_a Building Permit Application JAN 16-2019 ST. Lucie County, Permitting Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34.982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: PROPOSE101 MiRMROVEM ANT LOCATI N; Address: ewe 74 1 P a e e— Legal Description: Property Tax ID#: L4 /i 1 U' (=1 5• X0-I Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DET ULE ) DESCkIPTI'MW MF wORK• lid i (O .t fI I )A r 7 =CIMSTRUCTlON 'N1=ORMrATlO : Additional wor to a 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:$ J q . Utilities: —Sewer _Septic Building Height: OWNER/L!��SE • _ CONT A� UR; Name Name: Address: Company: City: _��r , P State: Address: Zip Code: Fax: City: State: Phone No. (,ik4L; l 3W Zip Code: Fax: E-Mail: 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. DESIGNER/ENGINEER: —Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Name: Address:` Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLEHOLDER: _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 inspecyon. If you intend to obtain financing, consult-with lender or an attorney before commencin r or#ecording your Notice of Commencement. fiFature'of Own'r/Ltssee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA } 1 - STATE OF FLORIDA COUNTY OF t\, Q) COUNTY OF The forgoing instrut was acknowledge efore me The forgoing instrument was acknowledged before me this-4 day of Jf�1�1 -- .20 by this day of .20_ by _�mhricwtrp,� 1'�1�1l�I � - Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced I - AA k (Signature of NotaryPub R N S. NIELSEN (Signature of Notary Public-State of Florida) State of Florida-Notary Public Commission No. e+ ccryg@ ion #GG 207484 Qc My CoO�mission Expires Commission No. (Seal) ,°,;;;°� June 12, 2022 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION' SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW, DATE RECEIVED DATE COMPLETED :Fe—v-. 'i' ar,,. fid•I' " ...rte...:{•! II Planning&Development Services Department f Building&Code Regulations - RECEIVED • 2300 Virginia Avenue Fort Pierce,Florida 34982 c (772)462-1553 JAN 16 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 l' able laws,ordinances,building codes,and zoning regulations. Initial f I understand that the building official and inspectors are not there to design or give advice on howl, 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 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 dical 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 tatement and that I further tJ understand that any violation of the terms of the owner/builder exemption shall be e o eN by the Building and Zoning Departqient to the Florida StAe Department of Professional Regulation. Si e anAcknowledged on this J day of, of 20 STATE OF FLO COUNTY OF C The foregoing instrument was knowledged before me this�day of 20 by I✓ who is personally known to me,or Ahohas produc as identification. Al A �A2!�:��; • Signature of NotaryType or Print Name of Notary (Seal) Title:Notary Public Commission Number ='. SLCPDSD Revised 05/15/2014 """"�F,/ KAREN S. NIELSEN tiOAY P(/B// i Notary Pu state of Florida ' Commission # GG 2074£34 ;i My Commission 022Pires June 12, ,�0 .._..va r � rpt. :., u � 7' z� x�, I1TSII�,IESr:-�O.�BD�.,7Z�8�1�`:�I_ERCE •FL��8�� . � g 45IS � � .St. Lucie Count , 1'701=13 � �t , y yf 205 1942EL a a RU E -TR 540 FF ' t 'E'scz�- �^-y�' S..-.B1 n '3-a•s4.`�"J �, � K t \ � L 4982- Amount Tendered; 519.00 `stbiicfsrct � ?` • s .��._�{.s.,, � 4h�•t n � � �.J�31 r3S �� 'vex \'T } '^.i?�c< T5` mount Paid: 519.00rx fT� 5�� (r - j` r\w. o '..,' u r c 15 � �"a..a � F'r,,-yc\-` yn S,.a°'� 1'^''yn'aQ � s Change Due;. 0.00 7 2 n K�� L h� Y Ad i �R i C€ iFx a yFf w � Thank You f 5IP '> e c t n T _6k ` 'Hfl tE#' k a 1VI0 ,I SIC-Losm DATE `t User ID: MURRAYA x to s e s �, SMw is '� r • 'FS Y s t :fit ^`+ - r Big, �* .�. ,� ,1`yy� i+„4fF s1k�•.y t s r E G. �s C"'' ustappica�o ��ereby�ec �a4aautfiortzetEt [JttllyoeadewaferandoFsage�sposal services to thereasesescabeaib� aa acco,�daucent1et�lttzes�r end or�utu�e�rates, ,_ rules an reguI onsuctyrexerenee areade pri of fFus catraet. 4ppGcanf agrees to pay\ '� a TOT r' ,CtT R.SDF?.t'OS s '' j!�, T NEfTI�rBI4L OR SFF.It�� ky�� max. .Scai+?..:�*l,J`a L'S7.. vT X. ,.''.C->t.:. �i "+e. 'S . .!.-�' WNM,r{^`1\ e OM „y x tet. t,ate�'!! .:i=Yt-(�'�wi t�- rc T""y S rr�,'-' S 1 F` A2.i�A-?�� t [[[��. k i 4•.' [ 4 A. �.: "'+�'.'Yy th. '$ WGIAM7 '% f a>` \ � '�+6, 4 l 4 t STO1�fER Tv h S J �S t- n •:T � \ t n ¢�p��++,��/},�' - NAMEDilQ{!S}: s V 1 r �E C ]ROM� D�4TE RECEDED CASH' # � � RECEIVED RECEIVED' • JAN 16 2019 ST. Lucie County, Permitting