HomeMy WebLinkAbout123 QUEEN ANN COURT CYPRESS CEILING COVERED PORCH0artL
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
91ro LUCI -�
V M F - Building Permit Application
Planning and Deveiopment 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: CYPRESS COVERED PORCH
PROPOSED IMPROVFA,A1zNT LOCATION:
Address: 123 QUEEN ANN COURT F UTCHINSON ISLAND FL 34949
Property Tax ID #: Lot No. J
Site Plan Name: VALENTINE Block No. 20
Project Name: _
DETAILED DESCRIPTION OF WORK:
INSTALL TONGUE AND GROVE CYPRESS WOOD OVER CURRENT CEILING OF COVERED PORCH, 430 SQUARE FEET
New Electrical Metec Secor�c Electrical Meter
_-cgNSTRUCTION INFORMATION:
Additiona: work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors Pond
Ele; ., lc _ Plumbing _ Sprinklers _ Generator Roof Pitch
Total Sq. Ft of Construction: 'Ato_ Sq. Ft. of First Floor: !-Izo
Cost of Construction: $ 6500 Utilities: —Sewer —Septic Building Height:
OWNF-.'LEFSEF: CONTRACTOR:
NamedOSEPH VALENTINE Name:
Address:123 QUEEN ANN COURT Company:
City: HLTCHINSON ISLAND, FLORiDA State: _ ! Address:
Zip CCc : 3494S Fax: City: _ State:
Phone € ,:.4C7-301-0158 Zip Code: Fax:
E-Mail:JOEVALENTINEaL'iVA' AWN.COM Phone Na
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 $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name: i MORTGAGE COMPANY: Nat Applicable
Address:
p �n Name: -`
City:Address:
� Zl -----. _ State: � City: State:
or.e Zip: Phone:
FEE SiIVIPLE T[Ti EH &LDER: Not Applicable ~I apNplryG COMPANY:
i Dame: —Not Applicable
Address: , Name:
city: Address:
y: r City.
I Zip: ,'none: Zip: Phone:
OWNER/ CONYRACTOR AF FIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no wore or installation has commenced prior to the issuance of a permit.
St. Lucie Coup tyy makes no representation that is grant;ng a permit will authorize the permit holder to build the subject structure
which Is in conflict with n _ ,, app,icahfe Horne Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. ?lease consul: t�,i_r, ,,our Home Owners Association and review your deed for any restrictions which may apply.
In considers;:a,la„tikig of this requested permi., I do hereby agree that I will, in all respects, perform the work
in accordan E Illt,l eFF. Jj12d pars, the �-orida Building Codes and St. Lucie County Amendments.
The fohow,ng building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory ;tructurLs, sw::nr,•,irg Pools, fences, wa°ls, signs, screen roorns and accessory uses to another non-residential use
WARNlN3 TC 71lt'1ER: YoL:r far''_,$ to Record a !`Notice U. Commencement may result in paying twice for
irri' p `v�en*s tc• RiOur property. A Notice Of Commencement must be recorded in the public records of St.
" Y d or h.ai0osite before the first inspection. If you intend to obtain financing, consult
4 — wit , r cr ar attornehefore commencing work or recording your Notice of Commencement.
I
5igna rf C��..';:;sseICcr:tr3.:`;rzs..gentfor
Otrner Signature of Co;�tractorJLicenseHolder
r ` STAT [: FICI:.!;,A� STATE OF FLORIDA
COUNTf OF SCeola _ COUNTY OF
I
5wovi tc ,r a?r .., ; ,4..scribed oefore me of Sworn to for affirmed) and subscribed before me of
Ph s' _a ?r 01.::.;e ',r.,a •:Zatior _ ah online Notarization
this— 'aY If — 0"6-kr 202C GY this�ydaa;� esence or
y zazo by
Name of :person making statement. Warne of person making statement.
Rersonc'.;n�..ciri.;a on Personally lCr,own OR Produced Identification
Type of lciv.,ti:ie7ti^r ype of lder3F;f:cation
Produce.. _ Produced
1
(5igndtu.- of o �L"—R(W*bMMISSI0N
'Signature of Notary Public- State of Florida }
Commis._. ;.. 0DWIGHT E. MAYNARD
4GG961079 a.r.missiun No. (Seal)
EXPIRES: February 23. 2024
' fZrV01 y n:. ,, ZLjI' r uG SUPERVISOR PLANS i VEGETATION SEA TURTLE i MANGROVE
DATE 1-ER REVI! W REVIEW REVIEW REVIEW REVIEW REVIEW
� �
RECEIVE
DATE — -- -- �-- --
COMKr FED
to,:-Sjc,..: - -- --�-
L❑ -- 1�i44�
U 4 . Planning & Development Services Department
e a, z _ Building & Code Regulations
2300 Virginia Avenue
Fort Pierce, Florida 34982
(772) 462-is53
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 nor hire an un:icensed person to act as your contractor or to supervise people working on your building; it
is your responsibility to snake sure that people employed by you have licenses required by state law and c my
or municipal licensing ordinances.
Initial Here.
If you sell or lease a building you have built or improved within one year after construction is complet , th-n 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 rfortn
the work being done. Your construction must comply with all applicable laws, ordinances, building c •s, and
2Dl`aii]a .4nalatios' Initial Here.
I understand that the building official and inspectors are not there to design or give advice on bow to cc the
minimum code, Initial Here.
I Laderstand that as an owner -builder that any contract disputes with sub -contractors and I must be handled "r a 'vit
co., : wits_ :tic advice of an attorney. This department will not mitigate any contract disputes.
Initial Here.
I n_n,ierstand t,)at if I compensate any person or company for work performed they are required to be license n this
jurisdiction. If for some reason they do not possess a license, I may be responsible and liable for the co the
license. Initial Here.
I understand that if any person that is unlicensed and uninsured gets injured on my construction project -the a • be
entitled to workmen's compensation. I could be held liable for all doctor, lawyer and related medical co ich
ccw,d h;c:woe less of wages duriug recovery from their injury. Initial Here.
To qualify for this exemption under this subsection, an owner must personally appear, sign the buildin errnit
application, and initial the above
I hereby acknowledge that I have read and understand ilia above disclosure statement and that l further understand
that any violation of the teens of the owner/builder exemption shall be rcporrcA by the Building and lonin�
D,tpartmotu to t:1,: Florida State Department of Professional Regulation.Vi ted acknowledged on this
day' of k L of 20 ", � j A _ ,
S`. _'.T E 0' .l
rr
Tl.::erea:..tl�t S..a�rSk';i:C.,. K:l.i uwiti::.���, izogcJ hai'Orc m4 this IlD—day of iz6e t
, 20 �
by __3Qe a '.to —who is personally known to me, or who has
as identification.
VOLyAO- rcA
o: No:ary Type or Pr ,t Name ol'Notar y (Seal)
Ti:: ; _ , ; ._ ,., i,. Cornnnission Number G1fDWIGHI h,ARD
MY COMMISSION # GG961679
14y6 �y0 EXPIRES February 23.2024