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Home My WebLink AboutBuilding Permit Application r All APPLICABLE INFO UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Dated - ' s Permit Number .F c2 Wyk V RECEv � JUL 10 2020 - ST. Lucie Count Permitting Building Permit Application y, Planning.and Development5ervices 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: IM ` SEEM_- -rya"'ke'� .t.-��t's,,...,.,�F..r,�.. +i+.',.. s_ ��„...��:.'�r.. Address: /firr^^D c^ Property Tax ID#: a, '� V V�� V Lot No. Site Plan'Name: Block No. Project Name: a-.��,-r��,�,�- cam°"b�: <t1� �3\�1't��,.'-,�.•it '�4,.,sue-.,a-:�'v�.r�..y^�w•,.'Y�'s � �.n.'�.*,''.'�b«a i xs "�C�4'vK�'� „-�. ��'�,a"s�;+e,� t.: �. G� � *�'� ��k�i��'.3,.,�,'�u"�'f"�� b�'��m`°�3,�,�.�d .w x-; *� tR K" 3 4 X •'#hv�4 s1.f .'3��`.L.- --b`-r. „'�.t f*'" ,,-„„n 9.. �.s.�.m._'^::_.M .... ,�.. New electrical Meter Second Electrical Meter x`" 5...,. r _ y r _ s �c3. 'ss.., ."^y`#.—p�` LL .a�ru�^ 4" 'n,f`. c "'- '-e 'imt x'i 3 ,r s'.� '- - � ^;' ':: �'a�"�'i5 Additional work to be performed under this permit-check all that apply: Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Pond f_ lectric _Plumbing _Sprinklers —Generator _Roof Pitch Total Sq. Ft of Construction: - Sq. Ft. of First Floor: Cost of Construction: $ � � �-- Utilities: _Sewer _Septic Building Height:. - 4GT YTI�A� � '...i. Name /yI154� 77- Name:. Address: �'S'�G J �G /�/�, Company City: /Uif Plelee- State: Address-...,r , Zip Code: .2�2V 2G Fax: City: t ' 'State: Phone No. Y5"/ '�/'f Zip Code:: :_ E-Mail: Phone No ;il in fee sirnple 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. F lig moo= WE 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 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 orand-covenants that may restrict or prohibit such structure.Please consultwith.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)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 recorcls of St._ Lucie County and posted on the jobsite before the first inspection.If you intend to obtain financing, consult with lender or an attorne before commencing work or recording our Notice of Commencement. Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder . 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 N tarization Physical Presence or Online Notarization this day of `,�_,20�by this day of 20_ by Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known . OR Produced Identification Type of Identification Type of Identification Produced U Produced (Signature of N - (Signature of Notary Public-State of Florida) KAREN S. NIELSEN otF��pFB,,, ,(Seal) Commission N __ ;State of Ftorida(SIm13}y Public Commission No. =* *= Commission # GG 207484 My Commission Expires REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. Planning&Development Services Di .lment M+ Building&Code Regulations T C 1l' 4 •, o 23001•'irginia Avenue Fort Pierce,Florida 34982 (772)462-1553 , CSTWdie L.1. 0 Z�ZD OWNER/BUILDER AFFIDAVIT DISCLOSURE STATEMENT County, Permitting 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 oven 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 structure's 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 h'7G If you sell or lease a buildiing, you have built or improved within one year after construction is complete;then a presumption-is created that itwas built or improved for-sale or lease,which-is a violation of this exemption. Initial A9 . 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;buildin codes, _ and zoning regulations. Initial ! I understand that the building official and inspectors are not there to design or give advice on"how.to meet the minimum code. initial `?44i I understandthat 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 A7/1 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 responsible and liable for the cost of the license, Initial 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 z L To qualify for this exemption under this subsection, an owner must personally appear and 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 shalLbe reported by the Building and Zoning Department to the Florida State Department'of.Professional Regulation. Signed and acknowledged on this day of of 20�e>. =-Own Builder Signature STATE OF FLORIDA . COUNTY OF, The foregoing ins rumen as acknowledge .before me this day of ,20_ by who is personally known , tb-me.,or who has produced 1, as identification.. Signature of Notary Type or Print Name of Notary (Seal) Title:Notary Public Commission Number S1.CPDSD Revised 0217120 '