HomeMy WebLinkAbout123 QUEEN ANN COURT INTERIOR REMODELIiAvvu
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
ODJ
-1r •:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential XX
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: INTERIOR REMODEL
PROPOSED IMPROVEMENT LOCATION:
Address: 123 QUEEN ANN COURT HUTCHINSON ISLAND FLORIDA 34949
Property Tax I D #: Lot No. J
Site Plan Name: Block No. 20
Project Name: VALENTINE
DETAILED DESCRIPTION OF WORK:
Replace 3 toilets, 5 vanities, retile 3 showers and replace flooring in upstairs and master bath. Retrace existing ceiling fans. Painting all bathrooms.
No moving of electric or plumbing required
New Electrical Meter Second Electrical Meter
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 _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 15000 Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameJOE VALENTINE
Name:
Address:123 QUEEN ANN COURT
Company:
City: HUTCHINSON ISLAND, FL State: _
Address:
Zip Code: 34949 Fax:
City: State:
Phone No.407-301-0158
Zip Code: Fax:
E-Mail:JOEVALENTINE@LUVALAWN.COM
Phone No
E-Mail
Fill in fee simple Title Holder on next page ( if different
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.
SUPPLEMENTAL CONSTRIJCT)ON LIEN LAW INFORMATION:
DE5IGNER/ENGINEER: Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE 51MPLE TITLE HOLDER: Nat Applicable
Name:
Address;
City:
Zip: ---. Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone: —`
BONDING COMPANY:
Name:
Address:
City:
ZIP: _ Phone,
___,_Not Applicable
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 Count makes no representation that Is granting a permit will authorize the permit holder to build the subject structure
which is In conWict 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 fuli 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 I de ran artorniaw before cornmencin work or recardin cur Notice of Commencement.
� n
as Agent for Owner
STATE OIgFLORIDA
COUNTY OF C'�sceola
Swor to (or afF:rmed) and subscribed before me of
P�'ysical Presen a or Online.Notarization
this-Atsday of er 2020 by
Jae
Name of person making statement_
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF
I Sworn to (or affirmed) and subscribed before me of
—Physical Presence or Online Notarization
this_ day of 2020 by
Name of person making statement.
Personally Known ✓ OR Produced Identification Personally Known
Type of Identification Type of Identification
Produced I Produced
(Signature of Notar blic-
Commission No.
! REVIEWS
RECEIVED j
DATE
COMPLETED
iIITE.MAYNA
ti C Mh1itiSii7fi }ii:ii4b
�o EXPIR.ES: February 23,
FRONT I ZONING SUPERVISOR
COUNTER I REVIEW I REVIEW
OR Produced Identification
L (Signature of Notary Public- State of Florida)
cmmission No. (Seal)
PLANS VEGETATION SEATURTLE MANGRDVE
REVIEW REVIEW REVIEW REVIEW
g L!o I LUU CL1LS
C.� Planning & Development Services Department
lilrllding & Code Regulations
2MQ Virginia Avenue
Fort Pleres, Florida 34992
M2) 452-15$3
OWNERI]R UILDFR AFFIDAVIT DISCLOSURE STATEMENT
)FS. 489.103 (7) EXEMPTIONS
State law requires construction to be done by licensed contractors. You have applied for a pertnit under an
exemption to that law. The exemption allows you, as tho owner of your property, to act as your own contractor even
though you do not have a license. You trust provide direct, on -site. supervision of the construction yourself You
may build or improve farm outbuildings, a one -fancily 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 leasit;g that building.
You may act dire ; 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 b y county
or munici ai licensingordinances. o
Initial Here.
If you sell or lease a building you have built or improved within one year after construction is comp]
Presumption is created that it was built or improved for sale or lease, which is a violation of this exemptio
en a
Initial Her
You may not delegate the responsibility for supervising work to a licensed contractor who is not licensed
the work being done. Your construction must comply with all applicable laws,
rform
zoning regulations. ordinances, building
es, and
initlal Here.
1 understand that the building official and inspectors are not there to design or give advice on how t
t the
minimum code.
Initial Here,
I understand that as an owner -builder that any contract disputes with sub -contractors and i must be hand]
court with the advice of an attorney, This department will not mitigate any eantract disputes.
n a civil
Initial Here.
I understand that if I compensate any person or company for work per fanned they are required to be lic
i this
jurisdiction. If for some roason they do not possess a license, I may be responsible and liable for the c
license.
the
Initial Here.
I understand that if any person that is unlicensed and uninsured gets injured on my construction project -the
entitled to workmen's compensation. I
ay be
con€d be held liable for all doctor, lawyer and related medical c
could include loss of wages during recovery from their ire ury.
ich
Initial Here.
To qualify for this exemption under this subsection, an owner must personally appear, sign the buil
application, and initial the above
permit
I hereby acknowledge that I have rear] and understand the above disclosure statement d that I further understand
that any violation of the terms of •ire owner/builder exemption shall ne cited the Building and Zo11W
Departn'g n o the Florida State Department of Professional Regulation, g a knowledged on this J 3 _
day of (7 I of 20 P , i j
Vl�ilal W G
STATE OF FLORIDA
COUNTY OF r? k
The foregoing Instrument was acknowledged before me this 13 � day of 0r,66e r , 20ZCs ,
i YA who is personally known to lne, or who has
produced as identification.
0. VuL cal
5igitatur o Notary Type or i t Name 7Jf Notary Seal
Title; Not ptzli is Commission Number ,QfA it) rn
+�""� DWIGl1T E. MAYIVARD
MY COMMISSION 9 OG961079
as fld F PMS: February 23, 2424