HomeMy WebLinkAbout5742 Sterling Fence PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date; _. � 1.,I a 7 ,0 Permit Number:
F�Ulo#
T Y
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: C)V3W( & P( C. ,�� nce
PROPOSED IMPROVEMENT LOCATION:
Address: _ �1 `i a 6 ACr_ 1 � 0 � CU Q(, FtV k
Property Tax ID #: R 1 ';L-. — So ;;I— — b I S (0 — fall. a — Lot No.
Site Plan Name
Project Name:
DETAILED DESCRIPTION OF WORK: 1
C-e_V Sim, 0;14,1+ In ct7, 11 �P� � u i..\
Qi i d(AL-,J -L'.C1c c. t iJ --N., GNU A<�, .� Arno ) 0 C6_ N 17 C, � rC if x ► ,,., t- r0 k. ►'1 Ce,.
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
r Electric —
Plumbing _
Sprinklers _ Generator
`� Roof Pitch
Total Sq. Ft of Construction:
2 ��i V
Sq. Ft. of First Floor: `�
(D'i/
Cost of Construction: $
Utilities: —Sewer —Septic
Building Height: 2
I OWNER/LESSEE: [CONTRACTOR: - . -
Name 11A, Rln ►h . )ka
Address: _C� S-1r ( 1 LA U Q
'� J
City: fbl i,'2;t CQe Stater,
Zip Code: 2LICIS-1 Fax:
Phone No -')'la L4 S in )
E-Mail: �% A&&Isc hC i Q VuLC - COfyn
Fill In fee simple Title Holder on next page (if different
from the Owner listed above)
Name: (l or1C
Company:
Address:
City: State:
Zip Code: Fax:
Phone No
E-Mail
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 INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGA E COMPANY: Not Applicable
Name:
_
Name: �^,r
Address:
Address: pa I?�D _ "1`14a3
City: State:
City: Ew State:N j
Zip: Phone
Zip: Phone: Roo aa3 L, Sal
FEE SIMPLE TYRE 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 IMPROYEMENTS 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."
Sig re wner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLQRIDA
STATE OF FLORIDA
COUNTY OF —,-A-. U ), i, e--
COUNTY OF
The forgoing instr ent was acknowledged before me
th' day of 20 by
The forgoing instrument was acknowledged before me
this day of 20_ by
r,
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
Pr duced
Produced
ANNNARIE CO
-
iGLIO
of Florida
(Signature of Notary Public State 1 •` Commission # G
3 4Sroature of Notary Public -State of Florida )
My Comm. Expires Nov
21, 2020
Commission No. Bonded through Nation
t on No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 217119
UW uo t—__%LZJr..:.0 Q1%
�� Planning & Development Services Department
V
a J r.==- Building & Code Regulations
2300 Virginia Avenue
Fort Pierce, Florida 34982
(772)462-1SS3
OWNERIBUILDER 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 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 trm
or municipal licensing ordinances.
Initial Here.
If you sell or lease a building you have built or improved within one year after construction is complete,
presumption is created that it was built or improved for sale or lease, which is a violation of this exemption.
Initial IIcrc.
You may not delegate the responsibility for supervising work to a licensed contractor who is not licensed to p
the work being done. Your construction must comply with all applicable laws, ordinances, building code ,
zoning regulations. Initial Here.
I understand that the building official and inspectors are not there to design or give advice on how to Sai
minimum code. Initial here.
I understand that as an owner -builder that any contract disputes with sub -contractors and I must be handled i
court with the advice of an attorney. This department will not mitigate any contract disputes.
Initial Here.
I understand that if I compensate any person or company for work performed they are required to be license
jurisdiction. If for some reason they do not possess a license, I may be responsible and liable for the cost
license. Initial Here.
I understand that if any person that is unlicensed and uninsured gets injured on my construction project -they m v
entitled to workmen's compensation. I could be held liable for all doctor, lawyer and related medical cosIL
could include loss of wages during recovery from their injury. Initial Here. in
To qualify for this exemption under this subsection, an owner must personally appear, 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 ownerlbuilder exemption shall be reported by the Building and Z4�iin
Department to the Florida State Department of Professional Regulation. S' ed d cknowledged on this 'T;1h
day of of 20_29
Owner der Signature
STATE OF FLORIDA
COUNTY OF -1 ,�,1 c_ e-
The fg�egoing instrument was acknowledged before me this 0 day of b
y __!;_0 v) d'_ S who is versonally known t me, or who has
otoduced ,d as identification.
.�
12
ignature of Notary Type or Print Name of No (Seal)
Title: Notary Public Commission Number
ANNMARIE CONIGLIO
�•1PRY PVB'
Notary Public -State of Florida
„ •_ Commission # GG 49655
My Comm. Expires Nov 21, 2020
11 WO, ' Bonded through National Notary Assn. `