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Home My WebLink AboutBuilding Permit All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: - ' Building Permit Application 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: 22 .s� a�D}IMPftOVEIVIE�NT LOCATIO'Nf ; _ 3sh rte f ,yi ;� � x,, ' Address: G -7 0� M �J� 9 8 9ti 7D Property Tax ID#: t J � Lot No. Site Plan Name: Block No. Project Name: 7 3 ficT% DETAILED DESCRIPTIONOF�WORW ' � (d?circ`c New Electrical Meter Second Electrical Meter g# r jb `CONSTRUCTION` INFORMATION r.::.�,�..._ �r„-,. .�..._� ez.J s.za.-.az_ .�txd*.G _..r ._......._.. :.. .. ✓t.._ _.r ,.�. 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:$ Utilities: —Sewer _Septic Building Height: 0- » �. lia..X^ £OWNER/L $EE 4 � x� A �}.CYC N RACT R ,w rtt Y Name Name: AddFess: & d Company: City: 4ylllzfCII_- State: Address: Zip Code: Fax: City: State: Phone No. 99.09-10 Zip Code: Fax: E-Mail: 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 DESIGNERjENGINEER: �Not Applicable MORTGAGE COMPANY: Not Applicable •~V 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 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 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 pasted 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. Signature of Owner)Lessee Contra as Agent for Owner Signature of Contractor/License Haider STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of Physical Presence or Online Notarization Physical Presence or Online Notarization th' day of 2020 by this day of 2020 by %avKe)3f person making sta ment. Name of person making statement. Personally Known OR Produced Identification Known OR Produced Identification Type of Identification Type of Identification Prvduced Produced gnature of Notary Public-St of Florida) (Signature of Notary Public-State of Florida) Commis �o L , ,u�'` =-�'` Commission No. (Seal) �tA�-RAFI�IING e ember 20,2022 $onded 7 REVIEV ,Nota ' i&fifers SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER R REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. O Planning&Development Services Department • Building&Code Regulations 2300 Virginia Avenue Fort Pierce,Florida 34982 (772)462-1553 OWNERBUILDER AFFIDAVIT DISCLOSURE STATEMENT F.S.489.103('n 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 cou ty or municipal licensing ordinances. Initial-Hee. If you sell or lease a building you have built or improved within one year after construction is comple e, then a presumption is created that it was built or improved for sale or lease,which is a violation of this exemption. Initial Her You may not delegate the responsibility for supervising work to a licensed contractor who is not licensed to perf rrn the work being done. Your construction must comply with all applicable laws, ordinances, buildin odes, and zoning regulations. Initial He e. I understand that the building official and inspectors are.not there to design or give advice on how t m et the minimum code. In He e. I understand that as an owner-builder that any contract disputes with sub-contractors and I must be handle in a civil court with the advice of an attorney. This department will not mitigate any contract disputes. j 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 co of„th license. Initial Here. 1 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 co 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 owneribuilder exemption shall be reported by t Buildin nd Zoning Department to the Florida State Department of Professional Regulation. Si and ac w ge o� this day of of 20_ Owner/Builder Signature STATE OF FLORIDA COUNTY OF�'� „A; The f going instrument was acknowledged before me this I day of 0 C ,2 /, by who is personally known to me,or who has roduced as identification. "'Sighature of Notary Type or Print Name of Notary LASHAHN ING M-RAHMING Title:Notary Public Commission Number MY COMMISSION#GG 275080 4 j:; P EXPIRES:December 20,2022 4j Bonded Thru Notary Public Jnd INA-:. . f