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Home My WebLink AboutBuilding Permit All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: zZ Permit Number: L-) 0 P 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: PROPOSED IMP MENT ATION: Q Address: J VIZP wO , U30,N jf } Property Tax ID#: Lot No. Site Plan Name: 7 vf- S Block No. Project Name: Er ETAILED DESCRIPTION°OF WORK: I-iv f 4l,r+ &kFr 4 /ox i y L 4A k d /W fit S 61 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: l y0 Sq. Ft. of First Floor: d27 Cost of Construction: $ o�y00, Utilities: —Sewer —Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name S1 Name: L /il ✓C'( Address: .-A Company: City: �-aa' State: Address: Zip Code: 3y531- Fax: City: State: Phone No. Aa-33Z.-GOy1 Zip Code: Fax: E-Mail:T`NU6.1 a �r,,� ,f 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. UPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: M'!E:6 At—'e-or 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 improvement o your property. A Notice of Commencement must be recorded in the public records of St. Lucie Coun d po n the jobsite before the first inspection. If you intend to obtain financing, consult with lenddr,6r a tgrdev before commencing work or recording our Notice of Commencement. Signa "of 0 ner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder ST TE OF FLORIDA . STATE OF FLORIDA COUNTY OF t4 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 this—_V,day of 2020 by this day of 2020 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 Produced (Signature of Notary Public-State f Florida ) (Signature of Notary Public-State of Florida ) Commission No. (Seal) Commission No. (Seal) nd T �0mm C6.n REVIEWS FRONT ZONING 2 ..1 , PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEWS REVIEW REVIEW REVIEW REVIEW DATE rn o C RECEIVED N m� DATE Nb w p COMPLETED ev. l famm Planning&Development Services Department N_ *� Building&Code Regulations 2300 Virginia Avenue Fort Pierce,Florida 34982 (772)462-1553 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 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 co or municipal licensing ordinances. Initial H e. 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. You may not delegate the responsibility for supervising work to a licensed contractor who is not lice to perform the work being done. Your construction must comply with all applicable laws, ordinances, building codes, zoning regulations. Initial Here. I understand that the building official and inspectors are not there to design or give advice on how to meet minimum code. Initial Here. I understand that as an owner-builder that any contract disputes with sub-contractors and I must be han a 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_2&e license. Initial Here I understand that if any person that is unlicensed and uninsured gets injured on my construction project-they may entitled to workmen's compensation. I could be held liable for all doctor, lawyer and related medical cos ch 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 statem a d that I further understand that any violation of the terms of the owner/builder exemption shall be repo ed B ilding and Zoning Departm it to the Florida State Department of Professional Regulation. Si ckn edge day of of 2021 . .;;6' &0" rBuilder Signature STATE OF FLORIDA �% ` COUNTY OF ;'S,�- L„y(�}�{_ o d= The foregoing instrument was acknowledged before me this day of S J ,20Z _n, 3 o D by who is personally known to me,or who `4 '3 C 3 N produced 1 V as identification. 3 o a m -- 1��, .�_-- ► are-ra�.��J Co P o ito Signature of Notary V Types-Print Name of Notary (Se t m v-n Title:Notary Public Commission Number ND.c O m PQ N Q Q n