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HomeMy WebLinkAboutUntitled All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: ®�/V11 Permit Number: RECEIVED Building Permit Application MAY 13 2019 Planning and Development Services Building and Code Regulation Division ST. Lucie County, Permitting 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT TYPE: PRfJP©SED I P AMMENT L•ii(,r2iION: Address: :7�tv,2 &v7oo,an Ff Pier-Ge Property Tax ID#: r `�t,y ® �• I Q 00 .� Lot No. Site Plan Name: Block No. Project Name: DETAILEI3 DE-�fiRIPTION OF iNO'RK: SfiO4"f �/�J' ./ca f)�.a, i eXiJr 7,7 CO STR+UCI'IC)N' I FORMATION: 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: $ 1,00.90 Utilities: —Sewer —Septic Building Height: O R/LE= SEE: n CONTRAC �R: Name rank t,,, Rev^eol c7r, Name: Address: ?E1'o-2 f4�n -f't Company,.:- City: State:F/ Address: . Zip Code: 34'7 ! Fax: City: State: Phone No. (C� 7�� S77 p49 Zip Code:. Fax: E-Mail: &4eais'2, C_W Id a!2/hAC'-?n 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. S .F4PA0 MENTAL CANS R± -CTt19,N LJ N I,AW IN O'RMATlON: 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. Zj�7-_ 3_gnatuf1rofVwner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF t4—WO)i -, COUNTY OF The forgoing instrument was acknowledged efore me The forgoing instrument was acknowledged before me this t—K day of 20_1_1 by this day of 20_ by /-' �]&I k- - aV6261til) � 1 Name of person making st a ement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identific 'err Type of Identification Produced J L Produced ;( iga ure ofNotary P (Signature of Notary Public-State of Florida ) pyp , KARE S. NIELSEN ` "' VB Commission No. =_° ScorCam tateof,Flo;+da Notary Public - = n # GG 207484 Commission No. (Seal) ;,?4,4 -`` My CJune Xsson 121 2022pires REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Te-v—. Planning&Development Services Department - ® Building&Code Regulations RECEIVED • 2300 Virginia Avenue Fort Pierce,Florida 34982 (772)462-1553 MAY 13 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 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 t 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 r the cost of the license. Initial A— 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—h— 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 3 A day of of 20 f-. OwnerBui der Signature STATE OF FLOI�I A COUNTY OF `� The foregoing instru .ent was ackn wl d d before me this TL day of ,201L by f; F. who is personally 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 KAREN S. N I E L S E PJ 3a° ;State of Florida-Notary Public) *= Commission #GG 2074£4 - ff: My Commission Expires "' `` June 12, 2022 SHOWER BASE �I BASE PARA DUCHAS see what pelta can do- BASE PARA DUCHAS / REGADERAS Models/ Modelos/ Modeles 36" 40054 B78513-3636-WH Write purchased model number here.Retain B78615-3636-WH these instructions for future use. Escriba aqui el nurnero del modelo comprado. Conserve estas instrucciones para usarias en el futuro. Inscrivez le numero de modble icl.Conservez <> ces instructions pour consultation. 48" 40074 B78311-4834-WH B78513-4834-WH We're here to help! Please do not return B78615-4834-WH your product to the store. For questions, installation support, missing or replacement parts,contact us first. iEstamos aqui para servirlel Por favor,no devuelva el producto a la tienda.Para pacer preguntas,obtener ayuda con la instalation, 60" piezas que le' falten o de repuesto, gontktenos primero. 4 0j DR4L 94 � Nous sommes la pour vous aiderl Ne 878311-6032E-WH retoumez pas votre product au magasin. Si vous souhaitez obtenir des renseignements, B78311-6032R-WH du soutien pour('installation ou des pi6ces de B78513-603OL-WH rechange ou si des pikes sont manquantes, 878513-603OR-WH communiquez d'abord avec nous. 878513-6032L-WH www.deltafaucet.com B78513-6032R-WH 1-800-355-2721 B78615-603OL-WH consumercare@deltafaucet.com B78615-60308-WH B78615-6032L_WH RECEIVED 878615-6032R-WH I MAY 13 2019 ST. Lucie County, Permitting FILE COPY www.deltafaucet.com 1 06/26/2018 101337 Rev.B RECEI\ MAY 13 11 ST. Lucie Count} FL r L V 00" 3