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HomeMy WebLinkAboutBuilding Permit All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: f 6Tf1 Permit Number: C41Y Q . CO Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential _ PERMITTYPE: Ro�� R�Pi~a��rti�,rrr' PROPOSED lNPFtOVENIENT_�LCICATION, _M J =— Address: ` �I_�?� ,l�c1 f1lLJ� PbC��, 11��1�� Property Tax ID#: a I9 ` ,< -oc o Lot No. Site Plan Name: Block No. Project Name: DETAILED DESCRIPTION OF WORK £ � . Al 61Num," ,rod 'Inl©wn -off bti .4 d vo m'dfya_s o ty_i'aA �air CONSTRUCTION INFORMATION Additional work to be performed under this permit—check all that apply: _Mechanical _Gas Tank —Gas Piping _Shutters _Windows/Doors _Electric _Plumbing _Sprinklers _Generator Roof Pitch Total Sq. Ft of Construction: Sq. Ft.of First Floor: a3�0 Cost of Construction:$ 15b0 , m Utilities: _Sewer _Septic Building Height: 01NNERJLESSEE CONTRACTOR Name Vic!5a0 ti( ,`i�J 1Kkte_QX Name C H ft PUE6 . J)i_VSA QX UA Address: 6I 5'( IJ APPI N 55 5?: Company.: 0W 0"r-,P-- e)il t —D F_f9— City: F-r. p 1_RCL Stater Address: 661 14#00I0€-b6 Zip Code: °( Fax: City: 1C(LL Stater Phone No. "1'M ao3 6519 Zip Code: q$1 Fax:. E-Mail: Phone No Fill in fee simple Title Holder on next page(if different E-Maill�_ 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 HVAC is$7,500 or more,a RECORDED Notice of Commencement is required. r 777 SUPPLEMENTAL C4NSTRlCTtON LIEN LAW IIVORMATION / ,y . -pp MORTGAGE DESIGNER ENGINEER: Not Applicable _X_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 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 your paying twice for improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before corr)m&ncing work or recording our Notice of Commencement. Signature of Owner/Lessee/Contractor ag Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA �-- COUNTY OFF- l Rom(_ COUNTY OF The forgoing instruient was acknowledged before me The forgoing instrument was acknowledged before me 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 Identifica ' n Type of Identification Produced CX_ Produced a (Signature of Notar ublic-State of Florida) (Signature of'Notary Public-State of Florida) Commission No. ELLE(PeVAUGHN Commission No. (Seal) State of Florida-Notary Public =• e= Commission # GG 270079 ;SoFFoe,� y ommissi n nPIre e er 2 _027 REVIEWS __ -_ IR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. / p Planning&Development Services Department RIP Building&Code Regulations M-190 -.. 2300 Virginia Avenue Fort Pierce,Florida 34982 (772)462-1553 OWNERBUILDER 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 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 complete, then a presumption is created that it was built or improved for sale or lease,which is a violation of this exemption. Initial Here. 4> 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, building codes, and zoning regulations. Initial Here. I understand that the building official and inspectors are not there to design or give advice on how to meet the minimum code. Initial Here. I understand that 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 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 cost of the license. Initial Here. �w 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 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 owner/builder exemption shall be reported by the Building and Zoning Department to the Florida State Department of Professional Regulatio Signed and acknowledged on this Co day of .sCY+ of 20 2. OwnerBuilder Signature STATE OF FLORIDA -L \_Q�2 COUNTY OF The foregoin in_strument was acknowledged before me this day of ,2� by S(bn Qe\R_(T u.-Ne who is personally known to me,or who has . produced �_— as identific ' ELLEN VA.UGFIN'� Q\ \. r7 \Fri ► q ;e° `:State of Florida-Notary Public *_ Coy] is ion #f GG 270079 Signature of Notary Type or Print Name of otary �FOFFt�� M` Wrnissior Expires Title:Notary Public Commission Number """'" October 22, 2022