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Home My WebLink AboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �� Permit Number: I ® ^ vro LU11co ' r RECEIVED R w , '' MAR 0 8 2021 Building Permit Application Permitting Department Planning and Development Services st. Lucie ounty 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 lMPROVEM,ENT LOCATION: CC��a-�Address: -3509 0 �P� PropertyTax ID#: �`-� -(� Lot No. Site Plan Name: Block No. Project Name: DETAILED DESCRIPTION'OF WO,RRKn` c 71 New Electrical Meter Second Electrical Meter r CONSTRUCTION tNfORn/IATION r 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: Sq. Ft. of First Floor: Cost of Construction: $ 2moll Utilities: —Sewer _Septic Building Height: 01NNER/LESSEE CONTRACTOR: Name Name: Address: D Company: City: L State-11 Address: Zip Code: 7� 47 Fax: A/TA City: State: Phone No. O,AR - Zip Code: Fax: E-Mail: M1 i_'35 0 0- ,oJ'. 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. 1 SUPPLEMENTAL CONSTRUCTION U(EN LAW INFORMATION: t 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 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 attorney before commencing work or recording our Notice of Commencement. `auk4m� w1 O 4--\ Signature of Owner/Lessee/C ntractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA L STATE OF FLORIDA COUNTY OF aif) I10& COUNTY OF S n to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of woV Physical Presence or Online Notarization Physical Presence or Online Notarization this�day of 2020 by this day of 2020 by n Name of person making statethent. Name of person making statement. Personally Known OR Produced Ide•� ��d Personally Known OR Produced Identification Type of IdFficn �� 0 '.;• ..F✓ /i�� Type of Identification Produced lr1, Jc� 23 Produced (Signature of Notary Public-State of Fl�r�a k MiHO13664 8Signature of Notary Public-State of Florida0, 0 ) Commission No. lrf I w v *,I)��bbceunb0��•�•o�O� Commission No. (Seal) Z///,jBZ/c STAM�� REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev, RLF IPlanning&Development Services Department Gr G `C' f, ->—� Building&Code Regulations RECEIVED 2300 Virginia Avenue Fort Pierce,Florida 34982 MAR 0 9 2011 (772)462-1553 Permitting a=Partment OWNER/BUILDER AFFIDAVIT DISCLOSURE STATEMENT S . Lucie County 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. In' 'al Here. i in one year after constructionMelete then a If you sell or lease a building you have bunt or unproved w th o yp , presumption is created that it was built or improved for sale or lease,which is a violation of this exemption. I "i Here. t delegate the res responsibility for supervising work to a licensed contractor who is not lice ed to perform You may nop y p g the work being done. Your construction must comply with all applicable laws, ordinances, building codes, and zoning regulations. In re. I understand that the building official and inspectors are not there to design or give advice o n hoao meet the minimum code. Ini ial e. I understand that as an owner-builder that any contract disputes with sub contractors and I must b handl in a civil court with the advice of an attorney. This department will not mitigate any contract disputes. Init�'al�H�e,Ke. I understand that if I compensate an person or company for work performed the are required to 1�lice-�- ed in this P YP P Y P Y jurisdiction. If for some reason they do not possess a license, I may be responsible and liable for the cost of the license. IT re. I understand that if any person that is unlicensed and uninsured gets injured on my construction project ' ey 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. I 'al H e. To qualify for this exemption under this subsection, an owner must personally appear, sign t e buil g 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 t the Florida State Department of Professional Regulation. Signed and acknowledged on this „ day of of 200 Owner/Builder Signatuke STATE OF FLORIJ�A,nt h166 COUNTY OF i The fore Din instrument, a knowledged before me this day of ,20 ��ADEN/SF��i by who is ersonall k own to me,or who, 'Issioy' •'�9�,��i� produced �(�YI Q, d� 1 identification. $vQ`9 �o� ez3,"o�A;' Signature of Notary Type or Print Name of b ry 1 "013664 ' Title:Notary Public Commission Number v�'yp°Oiled%to /%"Z1 C011 111 0��\#x