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Home My WebLink AboutBuilding Permit Application inn,? All APPLICABLE INFO MrS�BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: c I ll Permit Number: RECEIVED JAN 112019 Building Permit Applicati 13T. Lucie County, Permitting Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 / Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residentialy PERMITTYPE: IDAIP TEI.V �� I Address: C _ (4 L5. d Property Tax ID#: �-I V�' V .'1• 0WLo Lot No. Site Plan Name: Block No. Project Name: DETTAILEDDESCRIPTION OFeWORLC 'r 3 hr CO.NSTRIJCTI O,NINFORMA4TIC�N: Additional work to be performed under this permit–check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Electric _Plumbing c _Sprinklers _Generator _Roof Pitch ] J Total Sq. Ft of Construction: / 0 Sq. Ft.of First Floor: Cost of Construction: 1�t 010. Utilities: —Sewer —Septic Building Height: 01NNER/.LESSEE: CONTRACTOR :t Name ANLLE L�� Name: Address: Z�p j ��, u�rl M Company: City: PO) /T SZ W 64 State: Address: Zip Code:3 Fax: City: State: Phone No. 1 �ivl Zip Code: Fax: E-Mail: f7� p�LCS 900lo (!qln�r , 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. If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required. .SUPPLEMENl'AL CONSTRUCTION LIEN`,LAW INFORMATION: 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 recordingyour Notice of Commencement. Vlk � Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF The f, rgoing instrumL as acknowledg efore me The forgoing instrument was acknowledged before me this day of 20" by this day of .20_ by 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 0 1A (Signature of Notary Public-St a otlf 6�rida) �` 41 _Z'4SeQy State of Florida-Notary u i ature of Notary Public-State of FloridaCommission # GG 20 8Commission No. ;� Commission Exp r6fission No. (Seal) � June 12, 2022 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. Planning&Development Services Depart RECEIVED ® Building&Code Regulations o r 2300 Virginia Avenue Fort Pierce,Florida 34982 (772)462-1553 JAN 17 2019 OWNER/BUILDER AFFIDAVIT DISCLOSURE STATEMENT ST. Lucie County, Permitting 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 yourcontractor 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 allb e laws,ordinances,building codes,and zoning regulations. Initial_� I understand that the building official and inspectors are not there to design or give advice on ho 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 lia 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 relat edical 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 anviolation of the terms of the owner/builder-exemption shall be reported by the Building and -Z m Moe g Depart e Florida S�e(�epartment of Professional Regulation. Signed and acknowledged on this day of of 20". OwnerBuilder Signature STATE OF FLOil COUNTY OF TY foregoin instruirt wa acknowledged before me thisIT day of ,201 b ' f�(Tj who is personally known to me,or who has produced as identification. 0S. C�— Signature of Notary Type or Print Name of Notary (Seal) Title:Notary Public Commission Number SLCPDSD Revised 05/15/2014 tioYP�q, KAREN S. N I E LS E N 4—P State of Florida-Notary Public Commission #GG 207484 ? My Cornmission Expires June 12, 2022 Planning&Development services ASBESTOS NOTICE TO OWNER/BUILDER Building&Code.Regulation Division 2300 Virginia Avenue Fort Pierce,FL. 34982 Phone:(772)462-2172 Fax:(772)462-6443 January 17, 2019 CAMILLE A POLK 905 Lakeview DR Richardson, TX 75080-4909 RE: Building Permit Number 1901-0327 Disclosure Statement: State law requires asbestos abatement 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 you own asbestos abatement contractor even though you do no have a license. You must supervise the construction yourself. You may move, remove, or dispose of asbestos containing materials on a residential building where you occupy the building and the building is not for sale or lease or the building is a farm outbuilding on your property. If you sell or lease such building within one year after the asbestos abatement is complete the law will presume that you intended to sell or lease the property at the time the work was done which is a violation of this exemption. You may not hire an unlicensed person as your contractor. Your work must be done according to all local state and federal laws and regulations which apply to asbestos abatement projects. It is your responsibility to notify the Department of Environmental Protection of your intention to remove asbestos. It is your responsibility to make sure that the people employed by you have licenses required by state law and by county or municipal licensing ordinances. Owner Signature& Date 1/17/2019 9:01:16 AM