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HomeMy WebLinkAboutBuilding Permit AOL All APPLICABLE INFO MUST BE COMPLETED FOR{APPLIC4,TION TO BE ACCEPTED _ Date. "' y� 6 - I Permit Number: 0'?OU-01401 RECEIVED Building Permit ApplicationJUN 2 6 2017 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 PERMIT APPLICATION FOR: h (- re )"e PROPQJ Address: Y LA I a PReSs g L4�N E E+ i 2 Cie L 3 �$ Legal Description: C R12, Q N A G R()42 �--dT 15 S Property Tax ID#: ~1 3`1 1 8 d o2 S Q 00 r S Lot No. Site Plan Name: Block No. Project Name: Cf�czD I N'r) c)1'q e Setbacks Front Back: A 31 Right Side: Left Side: DETAILED DESCRIPTION OF WORK: A-09 9. PAD O A tJ E: � 4kk fl 1 0SZ S0- ri "'d 42^ ) 'r-j (J\eS ' ( Fiheg- Mes�Q CO FORM TION: Additional work to be per ormec�un er this permit—check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Electric _ Plumbiinng.��� _Sprinklers _Generator _Roof Pitch 1 Total Sq. Ft of Construction: Tom- 39(0 Sq. Ft. of First Floor: Cost of Construction: $ U Utilities: —Sewer _Septic Building Height: SSEE Name Lh n e I SQ)- vw eke11R Name: Address: 14 H )oq, Pgess L.lek N Company: City: E- , P i C L e State:.- Address: Zip Code: �>y q gcZ Fax: City: State: Phone No. `l�la - 3 S9 - 3 3-7 I Zip Code: Fax: E-Mail: 1 1 VA . Q6M 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. low SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMAT'IO 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 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 commencing work or recording our Notice of Commencement. Signatu4 of Own r/L ssee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA - � µ ! STATE OF FLORIDA COUNTY OFr " COUNTY OF The for oing instr t as a knowledge befor The forgoing instrum was acknowledged before me this ay of 20_ by ¢ Xc$ this day of 20 b mE m (n N< (Name of person acknowledging) mT= (Name of erson acknowledging) � a'm +�< cn� N (Signature of Nota e ublic-State of Florida ) (Signature of Notary Public-State of Florida) Personall own i�OR Produced Identification Personally Known OR Produced Identification Type of Identi Type of Identification Produced (— . Produced Commission N�J__ (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW RE EW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE Q� COMPLETED ev. 7/2014 it • Planning&Development Services Department Building&Code Regulations • 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 nothave 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 $75,000.00 as long as it is for your own use or occupancy.You may not build or improve said structures for the purposes of selling or leasing that building. If you sell or lease a building you have built or improved within one year after construction is complete, then a presumption is created that it was built or improved for sale or lease, which is a violation of this exemption. You may not hire an unlicensed person to act as your contractor or to supervise people working on your building; it is your responsibility to make sure that people employed by you have licenses required by state law and by county or municipal licensing ordinances. You may not delegate the responsibility for supervising work to ali ceased contractor who is not licensed to perform the work being done. Your construction must comply with all ap$li�a�i}e laws,ordinances,building codes,and zoning regulations. Initial_ I understand that the building official and inspectors are not there to design or give advice on how tort the minimum code. Initial-SX 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 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 lia 1 f 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 relat d ical cost,which could include loss of wages during recovery from their injury. Initia 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 shall be reported by the Building and Zgning Dep e t to the lorida State Department of Professional Regulation. Signed and acknowledged on this day of of 20�. OwnerBu lder Signatfire STATE OF FLORID r- COUNTY OF The foregoing instrume wj49wledged before me this day o 20�by Z who is personally o to me,or who has produced i ntification. h b XTY:W-�P?f*f_CV tgnature o tary Type or Print Name o otary (S I) Title:No ublic Commission Number SLCPDSD Revised 05/15/2014 AUDRv.Y B.HUMPHREY MY C0MCSISSi0N#FF 174772 EXPIRES:March 6,2019 oc Fy°P` Bonded Thni Notary Public Underwri(ars I i ST. LUCIE COUNTY z` ' '� BUILDING & ZONING 2300 VIRGINIA AVENUE ® FORT PIERCE,FL 34982-5652 © e 772-462-1553 FILLED LANDS AFFIDAVIT I, the undersigned, am the owner of the following described pro erty: q +-�y i s pR e s s i e e LA IJ e F+. �� eF C (Tax ID/Legal description/Address) for which I have applied to St.Lucie County for a Final Development Permit. In accepting this Final Development Permit,BP Number ,I acknowledge that as owner of the above described property,and in accordance with Section 7.04.01(D),St.Lucie County Land Development Code, I shall be responsible for assuring adequate drainage so that the immediate community WILL NOT be adversely affected. I further acknowledge that in granting this permit for the development of this property,St.Lucie County is neither obliged nor liable to provide for,or maintain in any form,adequate drainage off my property which will not adversely affect the immediate community. Property Owner Name Property Owner Signature Date STATE OF FLORIDA,COUNTY OF ACKNOWLEDGED BEFORE (ME�� THIS DAY OF 20� BY M I L C' l �1� I,1 07_f' `�cWH(7IS P SO ALLY KNOWN TO ME OR WHO HAS PRODUCED o • AS ID ATION. m"ou SIGNATURE OF N ARY TYPE OR PRINT NAME OF NOTARY (SEAL) NOTARY PUBLIC TITLE COMMISSION NUMBER AUDREY B.HUMPHREY MY COMMISSION 4 FF 174772 EXPIRES:March 6,2019 Bonded Thru Notary Public Underwriters