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HomeMy WebLinkAboutBuilding Permit All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: Building Permit Application 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 Residential PERMITTYPE: PROPOSED iMPR01/EM'ENT LOCATI s N. Address: i wa d r 2r el Property Tax ID#: (� - C (� = Lot No. Site Plan Name: Block No. .� I Project Name: DETAILED ©E=�SCRPPTION OF WOR 0\ c-' CONSTRUCTIONI INN 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:$ »� / Utilities: Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name t/1 �Jl (Name: Address: �C2 141'0- LdC�� 2KC, -,,CoMpany: City: �Q-.Y u— State:} Address;: 1`,. Zip Code: Fax: ,City; State: Phonel�.� Zip Code:- Fax: E-Mail: v. i Vl Phone No' Fill in fee simple Ti a Holder on next pag (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 CONSTRUCTION LIEN LAW INFGRMATIO'N: 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 thepermit 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 BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR ARATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." I Signature of Owner /Contr ctor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORID STATE OF FLORIDA COUNTY OF S� w� ;y-- COUNTY OF The for ing instrument was acknowledged before me The forgoing instrument was acknowledged before me this day of I�Zee-__ ,20_6 by this day of 20_ by 0 srnr,�-w cf,-, ertee- P( N4 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 o� (Signa ure of Notary Public-St e of Florida) n (Signature of Notary Public-State of Florida) �o �z c 3 m m Commission No. (Seal) o o Commission No. (Seal) cavi �'2 m3oom O y. ffu REVIEWS FRONT ZONING �t PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW1REVIEW REVIEW REVIEW REVIEW DATE N"w RECEIVED N w v2:� DATE COMPLETED ev. 2/7/19 i 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 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 Iong 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 JDZZ., I understand that the building official and inspectors are not there to design or give advice on how to meet the minimum code. Initial n c. 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 for tj cost of the license. Initial (� I/ 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 meth 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 anyy vto I anon a e erms o e o Zo�wg Department to the F1 ricIII illite Ell.iIII',III' en o r e day of _CC of 20-`T. ri OwneI(Su afore STATE OF FLORID-A�,_f, COUNTY OF SG �=L D The foregoing instrument was acknoedged before me this day of L ?�� ,20 wl 'P= by who is personally known to me or who h produced as identification. K o mm zgnature of Notary Type or Print Name of Notary (Se VO z;-,-4 civ, -2 Title:Notary Public Commission Number of 3 a.° m 8LCPDSD Revised 05/1512014 N 0 G)a� m o, x -n 0 CD N C Q ST.LUC VW� ' L�TTY UTILITIES P U BOX 2-8 FT PIERCE FL,34982 ST LUCIE UTILITIES DEPS 2300 VIRGINA AVE NAME .fiGt f s. 1 �Q FORT PIERCE,FL 34982 r r / 2019 12:15:42 ACCT # # ��t ��"'" DEBIT CARD DEBIT SALE SERVICE ADDRESS VOOW;4lXXXX8197 - k: MASTERCARD r� 3rd: U$DEBIT SUBDMSION LOT "1 BLOCK A0000000042203 7LL ' BILLING" #: 1219 :E 1 al Code; 151651 MOVE-IN/CLOSING DATE- PHONE#-: LJ 4ethod: Chip Read ISSUer PIN Bypassed This application hereby request and authorizes the Utility to render water aiid/or sewage disposal -' 10Uilt, $0'00 se vices to:the premises described above..m accordance with the Utilities,piesent,or future rates,. rules and regulations,which-by reference are made:a part of flus contract Applicant,agrees tapay AMOUNT $521.25 the.Utilitypromptiy for such services m accordance with the established rules and regulations.: J CUSTflN1ERS I71±I'OSITS ARE NUN NEG4TLABLE OR TRANSFERABLE. soclaL sEc -� 9:9.40 IiED ID „L 7j CUSTOMER COPY >r SPOUSE SOCIAL SEC s.,. .. n..:.,.,.... ._y ,r ; F CEXSE.ONLY. :.. DATE RECEIVED I' CASH . CHK# RECEIVED BY