HomeMy WebLinkAboutbuilding permitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 08/06/2020 Permit Number:
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Building Permit Application /
Planning and Development Services /
Building and Code Regulation Division Commercial Residentialy
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Jan -Paul R. Brolmann
PROPOSED IMPROVEMENT LOCATION: Lot No 3, Block No. 3, Coral Cove Beach Section 1
Address: 234 Bimini Drive, Fort Pierce, FL 34949
Property Tax ID #: 1425-701-0043-00013 Lot No. 3
Site Plan Name: 234 Bimini Drive, Fort Pierce, FL 34949 Block No. 3
Project Name: Like -for -like hot water heater, gas, 40 gallon.
DETAILED DESCRIPTION OF WORK:
Reptacmg hot water heater, like -for -like, for insurance purposes.
Current heater is a gas 40-gallon tank, new heater will be gas 40-gallon tank
Home owner, Jan -Paul R. Bolmann, will be competing the work as the owner of the home.
New Electrical Meter NIA Second Electrical Meter NIA
CONSTRUCTION INFORMATION:
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 4 Roof pitch
Total Sq. Ft of Construction. NIA 5q. of First Floor: 1675
``
Cost of Construction: $ �`^w��Utilities: - Sewer —Septic Building Height:
OWNERAESSEE: Jan -Paul R. Brolmann CONTRACTOR: NIA
Name Jan -Paul R Brolmann
Name:
Address: 234 Bimini Drive
Company:
p y:
City: Fort Pierce State:
Address:
Zip Code: 34949 Fax: NIA
City:
Phone No. 7723709876
State:
Zip Code: Fax:
E-Mail: brolmannjp@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 25DO 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.
Will It I T\S a
I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
GNER/ENGINEER: Not Applicable
Name:
Address:
City: State:
Zip: Phone
MORTGAGE COMPANY: Not Applicable
N a m e: s-1 m-*-p Ma
Address: 901 S—m..A-
City: RKtMOra State: v g-
Zip: 2=+ Phone:w+18wm
FEE SIMPLE TITLE HOLDER: /& Not Applicable BONDING COMPANY: 14ot 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 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 fallure 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 I der or an attorney, before commencing work or recording our Notice of Commencement.
4
ig ure of caner/ Les ee/Contractor as Agent for Owner
Signature of Contractor/License Holder
ATE OF FLORID
STATE OF FLORIDA
COUNTY OF LuLt -e_
COUNTY OF
Swor to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
P yslcal Pres nce or Online Notarization
_ Physical Presence or Online Notarization
this 14 day a 2020 b
this _____, day of .2020 by
IL, &I J VI)
e n of pe somaking statement.
Name of person making statement.
Z"srsonally
Known OR Produced Identification
Personally Known OR Produced identification
Type of Identification 11
Type of Identification
Produced — Colo +rplA�oZC�
Produced
ignature 6f Notary Publlc- State f
re of Notary Public- State of Florida )
d, NWYAY PublIC Srala o}
Commission NOC7NG.3D I�''(_Q�_ al}Cuphdia victoria
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Commi ion No. (Seal)
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 5/6120
L LOLL
1 l ` Planning & Development Services Department
E, Building & Code Regulations
2" Virginia A%came
Fort Piero, Florida 34982
(771)462-15"
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 ym 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 co p ,then a
presumption is created that it was built or improved for sale or lease, which is a violation of this exem on.
Initial Her
You may not delegate the responsibility for supervising work to a licensed contractor who is not licens perform
the work being done. Your construction must comply with all applicable laws, ordinances, building c C5 and
zoning regulations. Initial Here
I understand that the building official and inspectors are not there to design or give advice on hog set the
minimum code. Initial er
1 understand that as an owner -builder that any contract disputes with sub -contractors and I must be h 1 a civil
court with the advice of an attorney. This department will not mitigate any contract disputes.
Initial Her
I understand that if 1 compensate any person or company for work performed they are required to be I c sed in this
jurisdiction. If for some reason they do not possess a license, I may be responsible and liable for cost o the
license. Initial Here
I understand that if any person that is unlicensed and uninsured gets injured on my construction project- ay be
entitled to workmen's compensation. I could be held liable for all doctor, lawyer and related medi co w ich
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 b i i g permit
application, and initial the above
1 hereby acknowledge that 1 have read and understand the above disclosure statement and that 1 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. Sig and owled� on is
day of Y of 202E7. / `%/I'� 4� r(lA
STATE OF FLORIDA
COUNTY OF > - LiL►r_ke_
The f regoing instrument was acknowledged before me this day of 4LAquS4 2010
by )�2ton 4 au l 'Ero ! — d" n who is personally known ✓ to me, or who has
produced as identification.
�VeclC. rto✓e5
Signature of Notary Type or Print Name of Notary RE9
r Mond@
Title: No Public Commission Number f3 - I -23
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