HomeMy WebLinkAboutWetmiller Permit App and OB AppAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ? zol`aPermit Number:
O o •r
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce Ft 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address:
PropertyTaxlDM:aI 1 t }} 3.f
Site Plan Name: t✓eY K!reot rl 1 d r��
Protect Name: °°' °"Y
New Electrical Meter N � Second Electrical Meter _
Lot No.
Biotic No.
Additional wori<to be performed under this permit —check all that apply:
Mechanical _ oas Tank _ Gas Piping _ShuttersWindows/Doors — Pond
'Electric _Plumbing _Sprinklers _Generator Roof `Z Pitch
Total Sq. Ft of Construction: J 0 3 r Sq. Ft. of First Floor: ZC)0 0 — °r'c' F�f��
Cost of Construction: $ t 1 06 Utilities: _ Sewer y�Septic Building Height: 3: O
OWNER/LESSEE:
CONTRACTOR:
Name ,tr I k.rt li
Name: iJa Jel 5µ1 c
Address it's °'
(
Company:
r
City: 1 % '• < <' ` <_
Zip Code: 'r-p , Fax:
e
Phone No. ' -d- /
State: jLt-
- t `'1
Address:
City: State:_
Zip Code: Fax:
Phone No
E-Mail: f z>, P(rJ ,.
`r s } . ��' n
E-Mail
Fill in fee simple Title Holder on next
from the Owner listed above)
page ( if different
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.
SUPPLEMENTAL CONSTRUCTION
LIEN LAW
INFORMATION:
DESIGNER/ENGINEER: V Not
Name:
Applicable
MORTGAGE COMPANY:
Name:
Not Applicable
Address:
Address:
City: State:
Zip: Phone
City:
Zip: Phone:
State:
i
FEE SIMPLE TITLE HOLDER: Not
Name:
Applicable
BONDING COMPANY:
Name:
Not Applicable
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,
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 con Ilict 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 posted on the jobsite before the first inspection. If you Intend to obtain financing, consult
with lender or an attornev before commencing work or recording your Notice of Commencement.
as Agent for Owner I Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF a;I r COUNTY OF
Swor to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online NQQtarizatlon Physical Presence or Online Notarization
this J1 day of tom— 202Q by this _ day of 12020 by
Name of person making statement. Name of person making statement.
Personally Known _,,,/ OR Produced Identification Personally Known OR Produced Identlflcat(on
Type of Identification Type of Identifications
f�r4t;
Cominissian No.
(Signature of Notary Public- State of Florida )
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
S5Vo rLuCM
O Planting & Development Services Department
Building & Code Regulations
2300 Virginia Avenue
17014 Plerce, Fim4da 34982
(772)4624553
OWNER/BUILDER AFFIDAVIT DISCLOSURE STATEMENT
F.S. 489.103 (7) EXEMPTIONS
Stale law requires construction to be one by licensed contractors. You have applied for a point il 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 eons(ruction 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 walking on your building; it
is your responsibility to malce sure that people employed by you have licenses required by stale law and by county
or municipal licensing ordinances, f/r
Initial Here, tJ/
If you sell or lease a building you have built or improved within one year after construction is complete, then a
wesunwplion is created that it was built or improved for sale or (case, which is a violation of this exemption. (L"w
Initial Here. 1' �
You may not delegate the responsibility for supervising work to a licensed contractor who is not licensed to p/e`rfot•m
the work being done. Your construction must comply with all applicable laws, ordinances, building codes, and
zoning regulations. Initial Here. K
I understand that (lie building official and inspectors are not there (o design or give advice on how tdtncet the
minimum code. Initial Here. r=
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. j
Initial Here,
I understand that if I compensate any person or company fa' work performed they are required to be licensed in this
jurisdiction. If for some reason they do not possess a license, I nay be responsible and liable for the cost o fflne
License. Initial Here,
v
1 understand that if any person that is unlicensed and uninsured gels injured on my construction project -they away be
entitled to worlonea's compensation. I could be held liable for all doctor, lawyer and related nnedical cost, which
could include loss of wages during recovery fron their injury. Initial Here, � eIA
V
To qualify for this exemption under (his subsection, an owner nest personally appear, sign the building permrit
application, and initial the above
I hereby acknowledge Thal I have read and understand (he about disclosure statanent and that I Wither understand
that any violation of the terra of the owner/builder exemption shall be reported by [he Building and Zouin�
Deparhnent to the Florida State Department of Professional Regulation. Signed and acknowledged on this
day of '*i of2f
/f
O /Builder Signature
STATE OF FLORIDA
COUNTY OF 5/. ,arc,Ie
The foregoing instrument w,n acknowledged before me this day oft 20 '7�y ,
by 'r' 0 who is personally known v, to Inc, or who has
produced as identification.
DAVIDYOUNG
`b"4 f Commission #GG 339770
iguahreofN ar Typeot•PrintNanneofhl nary '•,' > a4liltesJune 3,2023
'title: Notau Public Commission Number ""gPY,F; •"` dad TNu Troy Fain lnsurance6oP206T019