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Home My WebLink AboutBlack and White0180All APPLICABLE INFO KAW BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number_ a a a d 3 FILED Building Permit Applirad7APR -- — "CEZVED Planning and Development services eulwfng and code Regulation DMsfon 1 6 202 2300 Virginia Avenug Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Resicie �ty, Per i PERMIT TYPE: PROPOSED IMPROVEMENT L&ATION: j Address: -Z/04-75- F%. mete /cam 3 PropertyTax lD#: a 3 /3— /3/.- 80a/_ p o Lot No. Site Plan Name: B106 f10 Project Name: DETAILED DESCRIPTION OF WORK 5 0 Lv>J� G✓ c7-74- /6/� ' cN4ar Wj A4 i CONSTRUCTION INFORMATION: Additional work to be performed under this permit - check all that apply: _Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Vindows/Doo _ Electric _ Plumbing _ Sprinklers _ Generator _ Roof ip Total Sq. Ft of Construction: Cost of Construction: $ % -5- 0 —oo Sq. Ft. of First Floor: _ Utilities: _Sewer _Septic Building Height: [OWNER/LESSEE: I CONTRACTOR: - I, city: P� % State: Gi Address: Zip Code:. GJ 3.7 Fax: may: Phone No. f5-0 Zip Code: E Mail: /1Z4�5C/firi/e/r ty R /�1q�L.�'a�� Phone No. Hq in fee simple Tide Holder on next page ( If different E -Mail from the Owner listed above) state or County LHxn I M value of construetlon ls 52500 ar more, a REODPDED No[roe nt eerremaae+ev.e cs ■c" H value of HVAC Is 57,500 or more, a RECORDED Notice of Commencement Is required. state:;t _ Fax: HOWAROCOOKK cp111i1bS1MBGGi5%i EWm 0dQbU22.2 I a� ewr+errr 2 2 ' SUPPLEMENTAL. CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: Name: -,V-NotApplicable MORTGAGE COMPANY: _,E:�NotAppli Name: able Address: COUNTY OF ow'o-X = Address: City: E: City: Zip: Phone State: —Stat Zip: Phone: this _ day of 20_ by FEE SIMPLE TITLE HOLDER: Name: ✓ Not Applicable BONDING COMPANY: _ of Appli Name: ble Address: Address: City: Type of Identification City= Produced Zip: Phone: Zip: Phone: (Signature of Notary Public- St C�W.Vrida )IDWARD CGDNER N,:m OWNER/ CONTRACTOR AFFIDVTT. 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 strcture which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohi 3it 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 YOUI I PAYING TWICE FOR .IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECOR 3ED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND D TO OBTAIN FINANCING, ONSULT MM YOUR LENDER OR AN ATTORNEY BEFORE RECORDMG YOUR NOTICE OF COMMENCEMENT-' Rev. 21//19 Signatur of Own r/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA \ STATE OF FLORIDA COUNTY OF ow'o-X = COUNTY OF The forg g instrum nt wasgcknowledged before me The forgoing instrument was acknowledged before me this 43ay of iiK / 20Z6 -by this _ day of 20_ by 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 (Signature of Notary Public- St C�W.Vrida )IDWARD CGDNER N,:m (Signature of Notary Public- State of Florida ) Comff"w K GG Commission No. y g (Sli"30doher22,202t Commission No. (Seal) os np° Yai0rE71�uddYMMaY75•� REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MAN ROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 21//19 / Planning & Development Services Department Building & Code Regulations 7300 Virginia Avenue Fort Pierce, Florida 34982 (772) 462-1553 OWNEWBUILDER AFFIDAVIT DISCLOSURE STATEMENT F.S. 489.103 O EXEMPTIONS I. State law requires construction to be done by licensed contractors. You have applied for a permit der an exemption to that law. The exemption allows you, as the owner of your property, to act as your own con for even though you do not have a license. You must provide direct, on-site supervision of the construction yours If. You may build or improve farm outbuildings, a one -family or two-family residence for your use and occup cy. You may also build or improve a commercial building at a cost not exceeding $75,000.00 as long as it is for ur own use or occupancy. You may not build or improve said structures for the purposes of selling or leasing that uilding. You may not hire an unlicensed person to act as your contractor or to supervise people working on your bu ding; it is your responsibility to make sure that people employed by you have licenses required by state law and b county or municipal licensing ordinances. Initial If you sell or lease a building you have built or improved within one year after cousin ction is comp ete, then a presumption is created that it was built or improved for sale or lease, which is a vio tiop pf ti E f �? a You may not delegate the responsibility for supervising work to a licensed contractor who is not lic toed to pe the work being done. Your construction must comply with all applicable laws, ordinances, buildin co es, ang oning regulations. Initial u zr° I understand that the building official and inspectors are not there to design or give advice on how to e t tJ� inimum code. Initial r= I understand that as an owner -builder that any contract disputes with sub -contractors and I must be Bled 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 regmr d to be licensed in this jurisdiction. If for some reason they do not possess a license, I may be responsible and liabI f r the cost of the license. Initial I understand that if any person that is unlicensed and uninsured gets injured on my construction they may be entitled to workmen's compensation. I could be held liable for all doctor, lawyer and related cost, which could include loss of wages during recovery from their injury. Initial _� I hereby acknowledge that I have read and understand the above disclosure statement and that further understand that any violation of the terms of the owner/builderexemption shall be reported by the Buil ' g and Zoning Department to the Florida State Department of Professional Regulation. Signed and acknowledge on this day of of 2.0 7111. / STATE OF FLORIDA COUNTY OF SI 1 r v .aA The foregom instrument was acknowledged before me this � day zl 20�� by �L� C��-N �.f� Dmn .(' who is personally known to me, or who ha produced as identification. s _�� ignature of No m Type or Print Nae of Notary (Sea] Title: Notary Pub is Commission Number SLCPDSD Revised 021/20 0 u af 0 U cl 0 U 9 44 N N rq u 1,45 -tBENNETT ROAD_ � ��iu-moi { l 17 AD - 17 Aa mpled BY: Re Properly Addromma- 1475BENNETT ROAD NOTES: FENCES VKXATE EASEMENT ALONG F FORT PIERCE. FL 34947 j LOT UNE. MK3LrL ESPVIOSA LAND SURVEYNG, W. IONS SW 190iN Skeet SU1103110 . 4P. 1 FL 33137 sumor P10W'.005)7404319 rAX0.13MOe"190 LB#6463 AN le AVWALT PAWS� 1,45 -tBENNETT ROAD_ � ��iu-moi { l 17 AD - 17 Aa mpled BY: Re Properly Addromma- 1475BENNETT ROAD NOTES: FENCES VKXATE EASEMENT ALONG F FORT PIERCE. FL 34947 j LOT UNE. MK3LrL ESPVIOSA LAND SURVEYNG, W. IONS SW 190iN Skeet SU1103110 ANAW. FL 33137 sumor P10W'.005)7404319 rAX0.13MOe"190 LB#6463 AN 11 P, AI L, K C," '� owc �nvr o P 161-4 llml�j loll N A-1 /OK (4/6;e l,� j n Al �l �/CSL Pte; GG3 �i37