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Home My WebLink AboutBuilding Permit Application z2k(D, � 0 All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: ng ti fit ��+3 .; MAY --- := Building Permit Applic tion Planning and Development Services ST: Lucie County,Permitting Building and Cade Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax:(772)462-1578 Commercial Residential PERMIT TYPE: '�— G- ` PROPOSED IMPROVEMENT LOCATION: Address: Je `5 Q/t, Property Tax lD#: rrP / Lot NoAKC:2'-- Site Plan Name: Block No., t� Project Name: DETAILED DESCRIPTION OF WORK: CONSTRUCTION INFORMATION: 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:$ IV6 Utilities: —Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name ° 1/22LIQ Name:- Address:.7,,Zj� Company: City: / State Address: Zip Code: Fax: /, -�/ City: State: Phone No. - c�U�-'Y�ica Zip Code: Fax: E-Mail: /kjf , (51 •moi Phone No Fill in fee simple Title Ho der 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. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _Not Applicable 4 MORTGAGE COMPANY: Not Applicable Name: + Name: / Address: I Address: City: State: i City: State: Zip: P one Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: I 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 LENDEROR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Signa ure of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF The oing instrument was acknowledged before me The forgoing instrument was acknowledged before me this-forgday of Vv'%o.�A 20-4,6 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 L O L Produced (Signature of Not - a e IEG o��t�� (Signature of Notary Public-State of Florida} a41 MY COMMISSION# 022023 Commission No. EXPIRES( t� 16' 20 (Seal) BoT ndedNctayblleUt�denvAtort Commission No. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. LL-11 _. L1t;i Planning&Development Services Department Building&Code Regulations 2300 Virginia Avenue Fort Pierce,Florida 34982 (772)462-1553 OWNERBUILDER 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 county 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, then i You may not delegate the responsibility for supervising work to a licensed contractor who is not licensed to perfo m I understand that the building official and inspectors are not there to design or give advice on how totlneavil I understand that as an owner-builder that any contract disputes with sub-contractors and I must be handled ig I understand that if I compensate any person or company for work performed they are required to be licensed ithis r I understand that if any person that is unlicensed and uninsured gets injured on my construction project-they ay be To qualify for this exemption under this subsection, an owner must personally appear, sign the building ermit I hereby acknowledge that I have read and understand the above disclosure statement and that I further under d, Department to the Florida State Department of Professional Regulation. Signed an ckn e d on this er sr COUNTY OF s byy�� 4 C- who is personally known to me,or who has Q e d r r Cr eEANNA MARIEG&Va COMM1S31pN A GG 022023 Signature of Notfilry Type or Print Name of Not iM1Fof��?;= � & x18,2020 '�«•• twy P�Ac Undmwilgrs