HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: c;)00-)- 0
RCCRVED
JUL 13 2020
Building Permit Applica, !on
Lucie Co Permitting
Planning and Development Services ST. L:County, Pe
Residential
:
Building and Code Regulation Division Commercial
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
*1_7
Address: a
Property Tax ID# 4�v 106)49 -01()6-- Lot No.
Site Plan Name: q.,?/< Block No.
Alep
Project Name: 13 o Lo L;c- . feo ce—
VDETAILED DESCRIPTION OF WORK:
W WOO;> an'd tv,m A".1 Te-v)o,. Ag- �1�foy e
SIV-14,4—y Ar
Q'ilne, AI*C, Cqalc.- '56 - A.
44,L v?
New Electrical Meter Second Electrical Mete A ar LaA
[CONSTRUCTION INFORMATION:
Additional work to be performed under this permit-check all that apply:
—Mechanical Gas Tank —Gas Piping Shutters windows/Doors Pond
—Flectric Plumbing Sprinklers Generator Roof Pitch
Total Sq.Ft of Construction: Sq..Ft.of First Floor:
oa
Cost of Construction: $. Utilities: Sewer —Se tic Building Height:
OWNER LESSEE: CONTRACTOR:
Name
&I)e7ae 1!�&
�e C Name:, Az7v- /Lznte e
Address: /_21 <;4' 11 ru Sde e-Wa&10 Company:
City: State: Address:
Zip Code: Fax. _ City: State:—
Phone No. 6749— 19IJ4 _sZip Code: Fax:
E-Mail: "qzc I-AI04 -t-Z9 IR�_�rtj QA4 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 HAVC,is$7,500 or more,a RECORDED Notice of Commencement is 'required.
LUGLLS
Planning& Development Services Department
P L 8 1� U Building&Code Regulations
2300 Virginia Avenue MSCEIVED
Fort Pierce,Florida 34982
(772)462-1553 J U L 13 2020
OWNER/BUILDER AFFIDAVIT DISCLOSURE STATEMENT i ST. Lucie County, Permitting
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 Here. q01
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 Here. 41,46
I understand that the building official and inspectors are not there to design or give advice on how to meet the
minimum code. Initial Here. 4A6
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. n
Initial Here. 'J
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 Here. /11
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 Here.
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 owner/builder. exemption shall be reported by the Building and Zoning
Department to the Florida State Department of Professional Regulation. Signed nd acked on this -�
day of l of 20.( . &OT
OiAmc&uilder Signature
STATE OF FLORIDA
COUNTY OF ST C ue�E
.The foregoing instrument was acknowledged before me this $�_ day of fit!�/ ,20 a c7 ,
by _JD �►t Qo/C/UC—C— who is personally known to me,or who has
produced as identification.
SANDRA FAYAD
Sand -0— Fiv Co M#GG2771M
Type or Print Name U Notry p 27,293
Title ota lic . Commission Number .20a4 3 ' ..; ltil~� otRaruatootlFinl