HomeMy WebLinkAboutPermit Package All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED(�
Date: 1- Permit Number:
AUG : 9 2020
0 a.,
permitting Departmen
Building Permit Application St. Lucie county
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:
PRC�}P"OWED IMpROUEMENT LOCAT1i43N: 2 (�
Address: 5../ I nj ��"T"C.+� {�. 1' 'r-P'J
Property Tax ID,#: 02,- 0 Lot No.
Site Plan Name: Block No.
Project Name:
d: TAILED DFC«RIPTION OF WOR
L
A e
New Electrical Meter Second Electrical Meter
CONSTR++ CTI'ON INFO- MATION:
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Pond
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: [a Sq. Ft. of First Floor:
Cost of Construction:$ ���•Q� Utilities: —Sewer —Septic Building Height:
OWNERjLE=�SSEE: CONTRAC�"OR:
Name d L Name:
Address: / Company:,
City: T F f 6� C� ,State: Address:
//// p —� 4
Zip Code: .25# 9Z Fax: City: State:
Phone No. 772— —'/00 Zip Code:" _,_-., Fax:
E-Mail:-130$F3111if1"q��R$T. 7- 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.
i
SUPPLEMENTAL �aNSTRUCTION Li LAW f �1"ORMA l0
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 ncj 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 attorney before commencing work or recording our Notice of Commencement.
S ature of Ow Lessee(/Con actor as A ent for Owner Signature of Contractor/License Holder
STATE OF FL RI A STATE OF FLORIDA
COUNTY OF�. �=`(�,I� , COUNTY OF
_Swc n to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
PAysical Pres nce or Online Notarization Physical Presence or Online Notarization
this day of 2020 by this day of 2020 by
Name of person rn kin atement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of[den ifi�ation Type of Identification
Produced L Produced
(Signature of Notary Public-S a is 1 _ (Signature of Notary Public-State of Florida)
,�tpp•PUa%, R E 7da;N
IN �74c
Commission No. �° � (5e,a of Fotary , issionNo. (Seal)
Commission
o; GG 20 4
My Commis
_June 12, 2022
REVIEWS FRONT ZONI } S VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW. REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
lev. 5/6/20
Planning& Development Services Department RECEIVED
&Code Regulations
2300 Virginia Avenue AUG �.91010
Fort Pierce,Florida 34982
(772)462-1553
Permitting Department
OWNER/BUILDER AFFIDAVIT DISCLOSURE STATEMENT St. Lucie County
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. 9.(K
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.
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 code and
zoning regulations. Initial Here. &1j
I understand that the building official and inspectors are not there to design or give advice on how to mee
minimum code. t�h'�'e�((
Initial Here. r;
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 Here.
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 he
license. Initial Here. ��
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. 7-9?
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 RegulatiFner/Buiflde
ede d on this
day of of 202Ct
e
STATE OF FLOR/I
COUNTY OF
Th reoing i sfrument was ackno ledged before me this--,_day of l 20
produced
1 «� who is personally known to me,or who has
by
produced
as identification.
B Etvo�o
�`w"11 ,
Lr 7.oZ ,Z i. ';0 03f
Signature of Notary Type or Print Name of Notary sejidx3 uoissi1eTitle:Notary Public Commission Number 484LeePl( } aeS ,
N3S-131N 'S N3�f del
Planning and Development
Services Department
' Building & Code Regulation Division
Inspectio' ns
Helpful Hints for Owner Builders
.Scheduling Inspections
• Inspections are typically performed the day after the inspection is scheduled.
There are two ways to schedule an inspection:
a. Call 772-462-2172 or 462-2165 between 8 a.m. and 5 p.m., or
b. Go to St. Lucie County's Website, click on permits, click on online building
inspection system.
1. Enter permit number
2. Enter confirmation number (this number is on the top of your building
permit next to the building permit number.)
3. Enter
4. Click on the request next to.the inspection you want to schedule.
5. You can schedule an inspection online until 9 pm Monday—Friday for next
day inspection service. On Friday, the inspection will be scheduled for
Monday. On Saturday and Sunday, the inspection will be scheduled on
Tuesday.
Day of Inspection
Go to St. Lucie County's Website, click on permits, click on daily inspection
schedule.
• Locate your address or permit number, the screen will show the inspector name
and whether the inspection is in the morning or afternoon.
• Inspections are listed in order of scheduled site visit.
• Inspectors are available by phone at the numbers listed below from 7a.m. until
4p.m.
Andy Wentz. .772-249-9502
Greg Smyth 772-370-0482
Walter Pride 772-370-2539
Dave Johnson 772-370-2548
Wanda Gahn 772-204-4237
Mary Chissoe 772-370-2543
Stephen Poreba 772-475-1063
Clyde Heffelfinger 772=200-6386
Doug Harvey 772-370-2542
St. Lucie Count�1- RECENED
08-19-2020 :17:16 ST LUCIE COUNTY UTILITIES- P.O. BOX 728, FT. PIERCE, FL 34982
7:16
1992%527 AUG 1.9 2020 NAME'F'F
MAXWELL ROBERT
5911 MYRTLE DR permitting department !/�
FORT PIERCE St.Lucie county ACCT.# 4%
FL 34982
Amount Tendered: 519.00 5911 MYRTLE
Amount Paid: 519.00 SERVICE ADDRESS
Change Due: 0.00
Thank You
SUBDIVISION IRE LOT 22 BLOCK 66
Jser ID: MURRAYA
BILLING ADDRESS
.
CFC/WATER EMAIL ADDRESS:
FPUA CFC PHONE#? MOVE IN/CLOSING DATE
CFC/SEWER
GUAR. REV. This application hereby request and authorizes the Utility to render water and/or sewage disposal
services to the premises described above in accordance with the Utilities present or future rates, rules
LATERAL and regulations,which by reference are made a part of this contract.Applicant agrees to pay Utility
$ $519 TOTAL promptly for such services in accordance with the established rules and regulations.
CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE.
CUSTOMER Q
SIGNATURE SOCIAL SEC/FED ID'k 0/1
NAME OF SPOUSE- SPOUSE SOCIAL SEC.
OFFICE USE ONLY
/DATE RECEIVED ( �"' CASH CHK# r2" 6 RECEIVED BY
l
I acknowledge Base Facility Charges beginning for water and/or wastewater on the day the meter and/or service is installed by
the County,regardless of when a customer connects to or starts utilizing the meter and/or service.
I acknowledge upon activation of service,I will be billed and am obligated to pay the Base Facility Charges.