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HomeMy WebLinkAboutUntitled All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: � O , ^ RECEIVED Building Permit Applicatiorl APR 2 2 2019 Planning and Development Services ST. Lucie County, Building and Code Regulation Division Permitting 2300 Virginia Avenue,Fort Pierce FL 34982 ' Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT TYPE: PROPOSED IN'PROVEADMITillLOCATION: Address: PropertyTax ID#: �-� � �J ��' o � ' d©C�'� Lot No. Site Plan Name: Block No. Project Name: DETAILEDADms DESORPTION OF WORK: � 1 � F OWNSTIE122 ION NS O ,MAMINO, . 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: $ 2— l.C/ Utilities: —Sewer Septic Building Height: OWN TROZ11=SSEE: OONTRACTOR: Name 0 Name: Addre s: Company: City: 6 State: Address: Zip Code: ' Fax: City: State: Phone No. Zip Code: Fax: a E-Mail: Phone No Fill in fee simple Title Holder on next ge(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.. SUP LEMENI"AL C©Nffl �IJCTION L EN 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 permix 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 ,re's'pects,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. i Signature of Owner/Lessee/Co actor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF IF, COUNTY OF The forgoing instru ent was acknowledge before me The forgoing instrument was acknowledged before me this .day of 20 by this day of 20_ by Name of person makingsement. Name of person making statement. Personally Known OR Produced Identification Personally Known . OR Produced Identification Type of Identificatio Type of Identification Produced Produced (Signature of Notary ublic p on REN S. NJ ignature of Notary Public-State of Florida% ) `=o1h Stat of Florida-Notary += fission # Commission No. _* �S@mmission No. (Seal) My omrn ssiJune 12, r REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW--. REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. Planning&Development Services Department Building&Code Regulations 2300 Virginia Avenue RECEIVED Fort Pierce,Florida 34982 (772)462-1553 2019 J n 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 ap li able 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 how tgakeet the minimum code. Initial 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_ 1 understand that if 1 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 nydigal 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 any violation of the terms of the owmer/builder exemption shall be reported by the Building and Zoping Departm t to the Florida State Department of Professional Regulation. Signed and acknowledged on this _ZZ day of of 20 O erBuilder Signature STATE OF FLO A COUNTY OF The f�going instrument was acknowledged before me this�� day of 1(i - ,20 , by ` e who is personally known to me,or who has produced as identification.' _. Signature of Notary Type or Print Name of Notary (Seal) Titie:Notary Public Commission KAREN S. NIELSEN iFpv . SLCPDSD Revised 05/15/2014 io et-state of Florida-Notary Public *= Commission 0 GG 207484 My Commission Expires June 12, 207.2 puinu .............................................................................................................................................................. ......... - .............. feo RECEIVED APR 22 2019 nty, Per FIl E' 0 Vd, E 01 � . .. ............................. .............. ............. ............... ............................ a 7,7:-::�.......... a a .......... ..... rr 4 .............. .... ... ........ ............... 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