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Home My WebLink AboutBUILDING PERMITAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: o ILU 9ww,". Building Permit Application Planning and Development Services Building and Code Regulation Division Commercial Residential 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: Address: -35 Forf--'Pi4ree �-1 3�982 Property Tax ID #: Lot No. Site Plan Name: Block No. 7— Project Name: New Electrical Meter Second Electrical Meter Additional work to be performed under this permit— check all that apply: _Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Electric _ Plumbing _ Sprinklers Total Sq. Ft of Construction: Cost of Construction: $ f _ Generator _ Windows/Doors _ Pond Sq. Ft. of First Floor: _ Roof Pitch Utilities: _ Sewer _ Septic Building Height: ' Address: 16!t VdfWoli M- Z_ City: State: IV V Zip Code: Fax: �' --CA Phone No. 6 94'9 " 'E6-3 �1 E-Mail:1N�cWm q Corl sl N v� `d+1 C'1 G yva-c 6s Fill in fee simple Title Holder on next page ( if different from the Owner listed above) Name: 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 HAVC is $7,500 or more, a RECORDED Notice of Commencement is required. DESIGNER/ENGINEER: _ Not Name: Address: City: State: Zip: Phone MORTGAGE COMPANY: _ Not Applicable Name: Address: City: State: Zip: Phone: FEE SIMPLE TITLE H Lmam : _ Not Applicable BONDING COMPANY: Not Applicable Name: Ma Name: Address: Address: City: 1;7 -sip City: Zip: Phone: Zip: Phone: DWNER/ 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 paying twice for improvements to your property. A Notice of Commencement must be recorded in the public records of St. Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attornev before cocniencine work or recording vour Notice of Commencement. Signature of Owner/ Lessee/C ctor as Agent for Owner Signature of Contractor/License Holder STATE OF FAA STATE OF FLORIDA COUNTY OF COUNTY OF Sworn to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of Physical Presqjnce or Online Notarization Physical Presence or Online Notarization this t01111day of,ff/i A-x 2020 by this day of 2020 by 07 Name of person making statement. Name of person making statement. Personally Known OR Produced Identification J Personally Known OR Produced Identification Type of Iden 'fication Type of Identification Produced n C_lCClly_ Produced (Signature of o - Statmi$ York (Signature of Notary Public- State of Florida ) Notary Pu , Commission No. No. 01K'.;"y 'a 70 ounty Commission No. (Seal) Qua 1 d in Na�VLO Expires September 2, 202Z Commission REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Kev. 5/b/LU 9Vo CZ011 Planning & Development Services Department ® ` ' Building & Code Regulations 2300 Virginia Avenue Fort Pierce, Florida 34982 (772) 462-1553 OWNER/BUILDER 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 a presumption is created that it was built or improved for sale or lease, which is a violation of this exemption Initial Hqre. 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 HHeem — I understand that the building official and inspectors are not there to design or give advice on how to meet the minimum code. Initial Herej 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. Initial HerA 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 liable for the cost of the license. Initial 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 medical cost, which could include loss of wages during recovery from their injury. Initial Her To qualify for this exemption under this subsection, an owner must personally appear, sign the builds ig 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 owner/builder exemption shall be reported by the Building and Department to the Florida State Department of Professional Regulation. Si and ac wled day of of-2-0 2,0 Z ® Owner/Builder S' STATE OF R9@ft=A bJ G cvk- COUNTY OF (14-MO.), The foregoing instmume was acknowledged before me this day of ��/� , 20 &D , by who is personally known to me, or who has produced (,r as identification Swunkrof Not y Type or Print Name of Notary KHAN Title: N-atW Public Commission Number Qi W-N(m(pq OU 70 Notary Public, State of New York No. 01KH6098170 Qualified in Nassau County Commission Expires September 29 201L