HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: o�° �� Permit Numb -/2:3�0 7
RECEIVE®
Building Permit Application JUL 15 2019
Planning and Development Services Permitting Department
Building and Code Regulation Division St. Lucie Count FL'
2300 Virginia Avenue,Fort Pierce FL 34982 County,
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Resi entla
PERMITTYPE:
PROPOSED IMPROVEME LbCATI
Address: .�
Property Tax ID#: b C� (0- 000/ Lot No.
Site Plan Name: Block No.
Project Name:
DE'TAILEI) DESCRIPTION OF WORK
I
CONSTRUCTION.INFORMAT,ION
k
a
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gras Tank —Gas Piping _Shutters _Windows/Doors
_Electric V Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ �c��� ` �9 (9 Utilities: —Sewer '_Septic Building Height:
'OWNER/LESSEE: CONTRACTOR
Name /Ute Name:
Address: 5-s-° �'vC`� .Company:
City: State: Address:
Zip Code: Fax: City. -- 'f State:
Phone No. Zip Coder 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.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRU�CTION LIENIAW 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 JOB SITE BEFOR„E THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YJXM LENDER OR AN ATrQRNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.”
i
Signature,6f Owner/Lessee Co ra for as Age o Owner Signature of Contractor/License Holder
STATE OF FLORIDA ISTATE OF FLORIDA
COUNTY OF l ,( C,(A� COUNTY OF
The for g instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of cul% 20� by this day of 20_ by
Name of person making statement. f Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
'Type of IdentificatiType of Identification
Produced G Produced
CLL
(Signature of Notary Pub'e-Stat o \ 'Il 1 Notary )
State of Florida-Not ry(8ii' re of Nota Public-State of Florida
Commission #GG 270079
Commission No. ,`al)My Commission Ve mi ion No. (Seal)
�gtEOf F� October 22, 2
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
Planning&Development Services Department
Building&Code Regulations
2300 Virginia Avenue
Fort Pierce,Florida 34982
(772)462-1553
OWNER/BUILDER AFFIDAVIT DISCLOSURE STATEMENT
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'u
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 toa 1' used
contractor who is not licensed to perform the work being done. Your construction must comply with all p fib
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
the minimum code. Initial
I understand that as an owner-builder that any contract disputes with sub-contractors and I must b
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 b
licensed in this jurisdiction. If for some reason they do not possess a license,I may be responsible and H e r
cost of the license. Initial
I understand that if any person that is unlicensed and uninsured gets injured on my construction Drol ct
they may be entitled to workmen's compensation. I could be held liable for all doctor, lawyer and relP
at
cost,which could include loss of wages during recovery from their injury. Initial
'o 'y
�l
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 Builftg and
Zoning Department to the Florida State Department of Professional Regulation. C1111ne'd and acknrowled d on this
_6day of J o-ki-4 of 20
OvVerjulllder Signature V
STATE OF FLORIDA + L
COUNTY OF; 5 C,
The fbreigoiritwas%acknowledged before me this t5day of, 2035,
byP__"(, C 2Y)n 140d&�Q is personally known to?ne,or who has
produced as identification.
C—11
C- IN I I A Irw
Signature of No Type or Print Name of Atary (Seal)
Title:Notary Public Commission Number �
08
a ELLEN VAUGHN
Wef_; =State
SLCPDSD Revised 06/13/2014 Of Florida-No-tary Public
commiss,
my C.M,09#GG 27007,9
mission EX Ires,
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` This application hereby request an'd authprszes the Utrlrty to render water and/or sewage disposal .
t GUAR,.REV
} �semaces toithe premzses descnbed abaue,u►4ccot ance with the t3tilities:present o�r!future rates,
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LATERAI, inles�}andregulatrans,which by reference are made,a part;of this contract,Applicant agrees to pay
e'' �`, atheK`Uhl t�!,promptly for such services i�,accordance with.the estabiished n�les:.ancl 4r lations.
TOMERS
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DATE RECBIVED
CASH RECEIVED BY
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JOSEPH E.SMITH,CLERK OF THE CIRCUIT COURT
SAINT LUCIE COUNTY i
FILE# 4587735 07!01!201911:38:07 AM
Prepared by and return to: OR BOOK 4289 PAGE 2493-2494 Doc Type:DEED
STACY CONSALVO RECORDING: $18.50
Manager Doc Tax. $1120 OD
Fee&Fee,PLLC,d/b/a Treasure Coast Title&Escrow .)
426 Ave A
Fort Pierce,FL 34950
772-461-7190
File Number: 19-085
Will Call No.:
[Space Above This Line For Recording Data]
Warranty Deed
This WarrantyDeed made thisAlyhlfne,2019 between Joyce A.Herndon,a single woman whose ost office
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address is 5514 Spruce Drive, Fort Pierce, FL 34984 grantor,-and John C. Landry, a single man whose post office
address is 5514 Spruce Drive,Fort Pierce,FL 34982,grantee:
(Whenever used herein the terms "grantor" and "grantee" include all the parties to.this instrument and the heirs, legal representatives, and assigns of
individuals,and the successors and assigns of corporations,trusts and trustees)
Witnesseth, that said grantor, for and in consideration of the sum-of TEN AND N0/100 DOLLARS($10.00)and other
good and valuable considerations to said grantor in hand paid by said grantee,,the receipt whereof is hereby acknowledged;
has granted,bargained, and sold to the said grantee, and grantee's heirs and assigns forever, the following described land,
situate,lying and being in Saint Lucie County,Florida to-wit: °
Lots 10 and 11, Block 73, Indian River Estates Unit Nine, according to the map or plat thereof, as
recorded in Plat Boole 10,Page(s)74,of the Public Records of St.Lucie County,Florida.
Parcel Identification Number:3402-610-0093-000/4
SUBJECT TO restrictions, reservations, limitations,and easements of record, if any; this reference
to said restrictions shall not operate to reimpose the same, and taxes for the year 2,019 and
subsequent years.
Together with all the tenements,hereditaments and appurtenances thereto belonging or in anywise.appertaining.
To Have and to Hold,the same in fee simple forever.
And the grantor hereby covenants with said grantee that the grantor is lawfully seized of said land in fee simple; that the
grantor has good right and lawful authority to sell and convey said land;that the grantor hereby fully warrants the title to said
land and will defend the same against the lawful claims of all persons whomsoever; and that said land is free of all
encumbrances,except taxes accruing subsequent to December 31,'2018.
DoubteThre'
In Witness Whereof,grantor has hereunto set grantor's hand and seal the day and year first above written.
Signed,sealed and delivered in our presence:
al)
Witness ame: PK emdon
'Vitness me: �
State of Florida
County of Saint Lucie
The foregoing instrument was Acknowledged before me this 2�day of June, 2019 by Joyce A. Herndon, who U is
personally known or[X]has produced a driver's license as identification.
[Notary Seal] Notary Public
Printed Name:
STACY MING
Cot4SALVOMy Commission Expires:
: mmission#GG 2103J00390
Co
=yrF Q�=Expire;6'ny28,2022
•.. BondedThruTro�Fa�nlnsurana380338570f9
Warranty Deed-Page 2 DoubleTime'