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HomeMy WebLinkAboutBuilding Permit Application J All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED A Date: 3`l 2 Permit Number: 'RECEIVED a Building Permit Application MAR 10 2020 Planning and Development Services ST. Lucie County, Permitting Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT TYPE: PROP SED t PROt/�MWNT OCATIC3N: Address: Property Tax.ID#: 34D-,• 806. 0095• C6•LQ Lot No. Site Plan Name: Block No. Project Name: DETAILED D=�S�R�tPTtO OF WORK: /A- t.�-� /ee /� + 1ti/ r/ !`LSCC Y�}� `!J �S t> sc9,,G �� b!r / of 7-S L 16/ Un'4 h1%,C C! 2 9 9 -C o n wc_S-f S lde o A&?c,- az,.5 ' ) ",,+A Col tci . 2-5-/q,;+6 s -i4 't4'-7- /o,�617 R�i et CONSTRMUCTION I INFORMA ION: Additional work to be performed under this permit-check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutteis _-Windows/Doors _Electric _Plumbing _Sprinklers _Generator : ._,: _Roof: ' Pitch ' Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction:$ '7100'00 Utilities: —Sewer _Septic Building Height: FEW,NER�7Y/iIUS�SEE: CON RACTO R: Name 9d'-p/y 1,�9 Name: Address:le/ 7e-L7f�n olt' Company: City: /2��'!' �/r��c State: Address: -_-- - - Zip Code: '3 y S 2 Fax: City: State: Phone No. T(,,l -?25 -o60 Zip Code: Fax- E-Mail! 11croid to vje2c �9/.0 o'— 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. EMBALM MENTALOW STR I© LEN LAW tN ORM TION: 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 BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR 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 ..L.l�J�, s COUNTY OF The foL�oing instru ent wa acknowledged before me The forgoing instrument was acknowledged before me this V day of 2076 by this day of 20_ by k Awc )®bar\to Name of person making statement.A Name of person making statement. .Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identifica4ion �� Type of Identification Produced � Produced (Signature of Notary Public-State of Flori a) (Signature of Notary Public-State of Florida) Commission No. o�`;rYPo% KAF� Its NIELSEN ;_ ;State o�FI_orida-Notary Public Commission No. (Seal) •_ Commission # GG 207484 �? acKA­ e OF F�0 �unla June 12, 2022 REVIEWS FR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. Planning&Development Services Department Budding&Code Regulations 2300 Virginia Avenue Fort Pierce,Florida 34982 RECE#V E b (772)462-1553 AR 1 M 0 2H ' OWNER/BUILDER AFFIDAVIT DISCLOSURE STATEMENT I F.S.489:103(7)EXEMPTIONS ST. Lucie County, Permitting State law requires construction to be done by licensed contractors. You have applied fora 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. 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. Initial 1- 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. Initial #1 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 L 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. l�L 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 liaba for the cost of the license. Initial L 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?ppdical cost,which could include loss of wages during recovery from their injury. Initial X11 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 Departm nt to th Florida State Department of Professional Regulation. Signed and acknowledged on this day of of 20c2a. Owner/Builder Signature, STATE OF FLORI _ COUNTY OF The f regomg instrume•t was acknowledged before me this �� day of. 19Y 20 , by V who is personally known to me,or who has produced as identification. Signature of Notary Type or Print Name of Notary (Seal) Title:Notary PublicXI ``oS�pY PV% KAREN S. NI'ELS-EN' - ,State of Florida-Notary public SLCPDSDRevised_02n120 ��` Commission#GG 207484 My Commission-Expires June 12, 2022 vV (�2 L s�sOd ,rS`f Od �q h Yj-j� I.pod ;2t o iOh( K-,,v 4 LLJ �� ;�M 17 Q MENWO LL2 1-4 ��noN inoE N E N n' W 0/-* /7 / XOhd �©l � SVI S� J �,s s