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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: � 1�)IS
I =APR3
Building Permit ApplicationPlanning and Development ServicesBuilding and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential x
PERMIT TYPE: Fence
1?RQPOSEQ- Mt ROV MENT LOCATION 48 0 SoufiE v �jd trait , x "
Address: 4820 Southwind trail 2
Property Tax ID#: l 1 I ) �" 0®0'�3 Lot No.
Site Plan Name: Block No.
Project Name:
x
OETAiLE'DDWO�..b ,.. _ __
Leve a' 3 4 � 4
Install 48"tall wood fence
CC NSTRUCTIt N INFURMAT{ON
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: 200' Sq; Ft. of First Floor:
Cost of Construction:$ 2100.00 Utilities: —Sewer _Septic Building Height:
011�NERI E-$§ft � CCtNT.RACTt7R
..� .anwe
Name Joseph W Fersch Name:SAME Owner Builder
Address:4820 Southwind Trail Company:
City: Ft. Pierce State:_ Address:
Zip Code: 34951 Fax: City: State:
Phone No.772-473-1410 Zip Code: Fax:
E-Mail:jtfersch@gmail.com 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.
Sk1PPLEMENTAL CONSTR `CTIN LIEN I.AW INFORMATf0N-.
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 AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signat r of Owner/ essee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA ` STATE OF FLORIDA
COUNTY OF o , COUNTY OF
The rgoing instmi e t wa acknowledged before me The forgoing instrument was acknowledged before me
thi day of yl 20M by this day of 20_ by
(22
Name of per on makings tement. Name of person making statement.
PersonallyKnown 7OR Pro Personally Known
Produced Identification y OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Notary Rublic-State of Florida) (Signature of Notary Public-State of Florida)
Commission No. KARERI I1NIELSEN
ate of F AIA-Notary Public Commission No. (Seal)
-* Commission # GG 207484
s
°iii" June 12, 2022
REVIEWS F PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
Planning&Development ices Department
UNTY Building&Code Regulations
3 A 2300 Virginia Avenue A^ 2 0 ?020
Fort Pierce,Florida 34982
(772)462-1553 ST. Lucie County, Permitting
OWNER/BUILDER AFFIDAVIT DISCLOSURE STATEMENT
F.S.489.103(7)EXEMPTIONS
State law requires construction to be done by Iicensed 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 Iaw and unty
or municipal licensing ordinances. Initial
If you sell or lease a building you have built or improved within one year after con ruction is
complete,then a presumption is created that it was built or improved for sale or lease,which is a violo4in of
this exemption. Initial
You may not delegate the responsibility for supervising work to a licensed contractor who is nottensed to
perform the work being done. Your construction must comply with all applicable laws,ordinances,buildin des,
and zoning regulations. Initial
I
1 understand that the building official and inspectors are not there to design or give advice oneet
the minimum code. - Initial
I understand that as an owner-builder that any contract disputes with sub-contractors and I musFehAandled
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 req ed to be
licensed in this jurisdiction. If for some reason they do not possess a license, I may be responsible and Iiabl f r the
cost of the Iicense. Initial
I understand that if any person that is unlicensed and uninsured gets injured on my constructi ro'ect-
they may be entitled to workmen's compensation. I could be held liable for all doctor, lawyer and relate in ical
cast,which could include Ioss of wages during recovery from their injury. Initial
To qualify for this exemption under this subsection, an owner must personally appear and sign a 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 owneribuilder exemption shall be reported by the Building and
�nnig Departpenttq the Florida State Department of Professional Regulation. Signed and acknowledged on this
day of of 20 .
STATE OF FLO AAl e
Ow e Buir.ignature
COUNTY OF
Th foregain,g ins t was ac owledged before me this day of ,20�,
by E who is perspnally known V to me,or who has
produced as identification.
ignature of Notary Type or Print Name of Notary
Title;Not Public Commission Number KA EN S. NIELSEN
41R B w
SLCPDSD Revised 02!7!20 `n,State of Florida-Notary Public
=* *= Commission#GG 207484
My Commission Expires
June 12, 2022