HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: -3 /a Permit Number:
RECEIVED
- - Building Permit Application
Planning and Development services MAH 12 2019
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 ST. Lucie County, Permitting
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMITTYPE:
• J
PROPOSED INPRC3VEM ENT'LQCATIOa?•
Address: y ��CiJC4 d/57l< AR. 1:iogT AC,4c-�- _ 3W9Kd
Property Tax ID#:_3G1o2 - 7 - O i Sa Lot No.
Site Plan Name: Block No.
Project Name: rWC6
DETAILED 0ESC;RIFTIDN OF WORK � s
3 F1r: . 6F G &07 7,9N Alt C Z YL Mz t,4CY . Fin c f 191 o.J,6 r/��
CONSTRUCTIC} INFORMATION
Additional work to be performed under this permit-check all that apply:
_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.$ 00 Utilities: —Sewer _Septic Building Height:
OWNERjl.ESSEE CONTRACTOR:
Name 6,4: Pl,,1.,.1C (A:b,,3 Name: /2MKA-7('4" L).RK
Address: 6/o(,, (tivu 6AI( bA. Company:
City: /--1.1 17T '41'rAC.E State: /t Address:
Zip Code: Fax: City: State:
Phone No. L/L 3g Zip•Code: Fax:
E-Mail: /0A.I.;e2,e YANoo. Cbz 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.
SUPPLEMENTAL CONTRUCTIN LII LAW I)uF�RMATIQN. r q
j
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.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Lo o,I E COUNTY OF
The f oing instrument wag acknowledged before me The forgoing instrument was acknowledged before me
this day ofAIVIA 204 by this day of 20_ by
NMI
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
(Signature of Nota — (Signature of Notary Public-State of Florida)
KAREN . NIEI-SEN
,_� ��-State of'F{P id -Notary Public )
Commission No. = ommisPOR4 GG 207484 Commission No. (Seal)
My Commission Expires
June 12, 2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLEMANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
4
Planning&Development Services Department
licou TY Building&Code Regulations RECEIVED
2300 Virginia Avenue
Fort Pierce,Florida 34982
M2)462-1553 MAR 1 2 2019
OWNERBUILDERAFFIDAVIT 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 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 9pplicable
laws,ordinances,building codes,and zoning regulations. Initial&4 C
'I understand that the building official and inspectors are not there to design or give advice on how to 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 J
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,"C
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
day of !''7ARC1. of 20 .
Owner/Builder Signature
STATE 017-KO
COUNTY OF i
The regoin i nt was ac rnowledged before me this day of 20
by V who is personally known to me,or who has
produced L as identification.
Signature o NUMry Type or Print Name of Notary (Seal)
Title:Notary Public Commission Number
SLCPDSD Revised 05/15/2014 KAREN S. N I E L S E N
��pPY
P&
'�
=o State of Florida-Notary Public
_. Commission # GG 207484
Q My Commission Expires
�''�n°;i;°�` June 12;2022
J IIIC /U.FL 11WIU UUM UI LIIIb JU/VCy WUb. J.G7.1/ UPUULU 1 I.GV.IU
4 This Survey was prepared using the Plat of Record only. No other documents
Flood Zone Data derived byy scaling methods of the official FEMA Maps and limited were provided and no search of the public records was performed by this
to the accuracy of such maps. office.
Flood Zone: X Community #: 120285, Panel #: 0281 Suffix: J, Date: 02.16.2012 5 The Survey shown hereon meets the requirement for field accuracy in a
suburban area as set forth by the Minimum Technical Standards
(5J-1 7.050-052FAC).
1 6 By acceptance of this survey all parties agree that the signing surveyor's
liability is limited to the amount paid for said Survey.
Servke Pate Na89 54'34" E 299.66'(Measured) Let is,a/oak 19 P 7 Unless other wise noted all bearing and distances are in accordance with the
en
Line S90-00-00E J00,00'(P1°`I enact unc i,,,a. record plat and have been verified by field measurements. See map for bearing
base.
x8e.o g °gxe6. 8 Parcel/Lot line locations have been based on found survey control along the
{ _ x98.J J� to center line of Silver Oaks Dr.
16.2'• oc 9 LEFT BLANK.
Let s.Block 19 I i a 10 The Legal Description shown hereon was provided by the client and/or
r x r xstrayy en }arde po
EI.88.II w his/her representatives.
11 No ownership of fence lines has been determined asart of this Survey.
p
12 Off set calls to found survey control are relative to the nearest property
corner, intersection of lines, point of curvatures (PC), point of reverse
.6 - s '^3 �.fono.I ,,,, ----32.1•-- x87.5 $
Tt1+2iS 1' __
curvatures PRC or other identifiable point.
t .i ep .
' 4 w on.Stay RpH.rlce !, t/,,, c a 13 Compliance with local zoning requirements and or with requirements set
4 Sloe Sflwr oak Or. ; j,ferdened;;. ; w forth b other State, Public, and/or Private entities has not been verified as
1 y
ROM,-Berxh Mark 1 i!/.Pool me'I part of this Survey.
14 Elevations shown hereon are assumed
Well
_ ,,. .
m1 Cokrerp '^ I---------=---
r------------------128.9 ' i--------------- 6ttiroD+C
w r a c ----------------------
77
o
L -- f//
r T• ?: I a at (p 1 l J <ki' C 1 4,..,.r 1'..Y.3,..1
4 P tea'.. II t 'F O
Fenn 1 I �3 � a
Aar..* COhc ' GAC N 36.0' i ,
0.91 Aa * Lot12o,Black 19
22.
L }
6' N
n ; I 4e One Story Residence
i 4'Hog N7re Fence I § t F N 6106 Silver Oak Dr. !,• .,'' ��,// ,
S90.0000 E J00.00•
nRa
N 89"59'18" iY 299.90' -Lae.2t eras e— 7855 r�
Reference Bench Mark
REC55 V9-
Finis a TIoo�TDiTOD
O�—
MAR 12 2019 I t,T•0' 121 35,6
PLEG D _ __
FILE u 4 x4'Conerete Monument t'2 'tl. }'
C/E Covered n�T. Lucie County Per�'y��}Irl�f ...
r '"FlP--Fdun }'Iron Pipe `` ./.'O..
OIC-Concrete 7
.D FOR: CBS-Concrete Block Structure FlPC-Found Iren Pipe with Cop RLS20J5' `� ru ;'� /•: •�" `
nerica Mortgage, Inc., its successors and Or CMP-Corrugated Metal Pipe FlR-Found 15 Iron Rad 1.2 -'
/ Cone.-Concrete FlRC-Found/5 Iron Rod with Cap 185543'
s their interest m0 appear CPE-Concrete Pad with Pool Equipment SIRC-Set 15 Iron Rod with Cap U/7357' (J -_
y PP CN-Cable TV Box FlPC-Found 1/2'hon Pipe with Cap O 8.05' 14,6.'- -5.8'
EL-Elevation
w Group, PL FM-Found Mag Nail
FFE-Finished Floor Elevation FMD-Found Mag Nail with Dfak I rl.
'lic National Title Insurance Company GV-Water Gate valve FN-Found NalChibas and Patricia Ann Chibas HrD- re Frydr°nt FNrT-Found Nal with Tn Tab 0/L-Overhead UUlily Une SNTr-Found Nall with Rn Tab i MPP-Power PoleFPK-Found PK NailNPP-Wood Power Pole FPKD-Found PK Nal with Disk
BB Re Ina C. Karver PSM 4363 TCB-Telephone sewer Manholes Box ERRS-Found Rail Rood Spike 36.6' Detail of 1"=20'
y: g , # SSMH-sanitary Sewer Manhole /CO-In Pavement Cut Out
purveying, Inc. LB#7357 ue-ullty Bax
WM-Water Meter i I
I
i
mte. aavrsr n Descrr t"" Sheet Tltler
KARNER SURVEYING, INC. 11.29.18-Up ate. El. Pro.Bldg Boundary Survey
f PHILIPE CHIBAS & RESIDENTIAL & COMMERCIAL SURVEYING SERVICES I'M*]97An ren xt—f;,, n— Rlvi 41-9A