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Home My WebLink AboutBuilding Permit Application AK APPLICABLE I NPO;MU.ST BE COI PLETED FOR APPLICATION TO BE ACCEPTED cc�� Date: 7i � Permit Number: mac. c.w�`yeiie..6.;�y� �x��ti.E'�' ��`n.��°m-v�>n:.;¢� ,F:; ��p/�• 0�3 s i uIlding P.er�iit Pl��c;�#ion Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue,Fort,Plerce FL 34982 '!hone..:(772)462A553 Tax.: (772 462 :1578 -Cam =Re�sident�.a�1 r PERf1 ITAPPLICATI:ON FOR: - ...} Address. j1� U2_. Iverc� legal.Descripti.on.: �i /Ife�tflL� __ .. _P.roperiyTax.tD..#: Lot.No. Site'Plan Name: wu%ko Block No. Project Name: . Setbacks. Front Back: Right Side.:. Left Side: ,y '�"a' '� ..,, � 2�•.,r z. hk �- sr. �+x} Fs> 1 4x-�'L�. ''>3'r U nj � +>'{� r�hs3�F' ��r��°..r .yF. F'i� ��- 4 r s ,"+� r,e � ,.7„ rp.,..� f - .1. cG., I ittona. vvor to performed un er.this.permit.—ch.em all.that ap.p y,.,�. _Mechanical _Gas Tank —Gas Piping _Shutters. —Windows/Doors Electric _Plumbing _Sprinklers _Generator _Roof Pitch Totaf�Sq. Ft of Construction: Sq.Ft.of First Floor: . d st..of Construction-I -Utilities- ._Sewer _Septic B� itag.Height: P1IELESS � ....�__,.. ..__..,._._"'_<'. ,is:.w ..._,..,rt.� f-i�..<,'C ,...�..>:. .....�. ^�`.r.„_:.:...-Y .:t-`E.>;.r -'. . ,- 's m' F r' �i x-r z✓ Name . Q., Name: 'Addre L �-- City: _ State: Ad.dre t1142, .p. . Zi Code: Fax 3? —Q�� City - State. Ph ane N 7 Zip�.CodeA Fax:/T E Phon-e�No SS fill.in fee tmple;Title:Holder do next;page(cif different. E-Mail.. from the OWner 11 d 'above). State or County License .-If valise of coristiVdion is 25- or-:irrore,%-�RECORDE-D-Nbtice'of Commencementys-required. i K ONO ��/j k! jRg S Y' z-a k"- 3 �s �r�>�., vi SR. 7•73Jf� s --s.,-4 a� 5�: +� 1 i 16 rs�`e tr ,r r h-.n� � ... v ..a 3 DESIGNER/ENGINEER - of Applicable MORTGAGE COMPANY: Applicable Name.. Name: Address: Address: City: -- State; Cutyw 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 dot.he work and installation as'Indicated. I` ertify 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'con!icierat-ron df the:granting of.this-Tequested.permit, I do,hereby agree that:l=will,sin all:respetts-perform the work waccordance with;the;a,pproved.;plans,:the..Florida:Sailding Codes and S.t.::Lucle:County Ame'ndinents. 'tie foiiowingbuiidingpermit applications are exemptfrom undergoing a f0i concurrency review: room additions, accessory structures;swimming pools,fences,walls,signs,screen rooms and'accessory uses to another non-residential use i U4IARNIIUG TO';OiNNER:_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 befog the first inspection. If you intend to obtain financing;consult with lender or an attorney before cmMericoz work or r cordirr our Notice of Commencement. S.igna ure of Owner/Lessee/Contractor as Agent`for Owner Signature of Contra ctor/Cicense Holder STATE O FLORID STATE OF FLORIDA -COUNTY:OF:� � �( COUNTY OF —,LV� ,Tfa,.e. going instiu nt:was ack-iowtedged efore'-me. The: going ins . nt.was acknowled ed eforeire this da :of 2 ® p-b this da a�f 2 4�by g v by L; r; r L L. (Name of pbrson acknowledging) (Name of p on acknowledging) Z. ig ture.ofNotary R.ii State of Florid . , ( � at re.of.Notary.Public-St a of.Flori.da): Personalty.Known OR Produced lcJentlflcation y :Personally Known OR..Rroduced=ldentficaxion Type of.ldentification Type-of Identification Produced Produced .. a2YL>�L�J 9tCiC�4'C1�T1'i.+ � d ,V.P�✓/ly..� i. iI IASH,4HNAINGRA H ING Commission No ;;��",P IASHAHN� M-RAHMING Commission N I MISSION#� �060 Y COMMISS 0 GG 275060 " EX P►RES:December 20,2022 �?=a= EXPIRES:December20,2022IL ii - P _one ru No6ary P Vic Undervnilers. �� REVIEWS FRONT., 20 1N -- ' R., PLANS `.VEGET ON -SEA-TURTLE MANGRbVE COUNTER. REVIEW...- REVIEW REVIEW REVIEW REVIEW REVIEW :.DATE::.. . ... . RECEIVED I DATE GQMPLETED.:. . ..: ev... O Planning&Development Services Department 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 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. 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 code 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 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 thee� license. Initial Here. 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, wh' h 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 Z ng Depart mt to the Florida State Department of Professional Regulation Si ned and acknowledged on this day of' of 20n. er/Builder Signature STATE OF FLO , COUNTY OF L1�/The regoing instrt ment was acknowledged before me this day ofo °20 Z1/ by who is personally known to me,or who has *tie: VV __ as identification. i f Notary Type or Print Name Notary ` y Public Commission Number O.Vv Z,14: LAS,AHNAINGRAM RAHMING MY COMMISSION#GG 275060 I EXPIRES:December 20,20l.2 ? Bonded Thru Notary Public UndanNeit I