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Home My WebLink AboutBuilding PermitAaunoD apnl ;g IUMVPde�cl 6u133l .10d Residential IZOZ 6 0 ON 43/1I3J32i f \ 3�Aae z All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number Building Permit Application 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 PERMIT TYPE: Address: S1 I(Ain rcL 4,r-,\\ �+ �,<r« Property Tax ID #: Site Plan Name: Project Name Y Additional work to be performed under this permit — check all that apply: _Mechanical _ Gas Tank _ Gas Piping _ Shutters Electric _ Plumbing _ Sprinklers _ Generator Total Sq. Ft of Construction: Sq. Ft. of First Floor: _ Cost of Construction: $ S 1 9 Utilities: —Sewer _Septic Lot No. _ Block No. Windows/Doors Roof Pitch Building Height: WIN 01 Name M1 Name: Address: 5°I10 (tg,..a.t Company: City: < State: F Zip Code: 3`'182- Fax: Phone No. "12. 33l .1101 r Address: City: Zip Code: Phone No State: Fax: E-Mail: USeI' Z5y 3 CO 6w 11 < c "^ Fill in fee simple Title Holder on next page ( if different from the Owner listed above) I E-Mail State or County License � If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required. DESIGNER/ENGINEER: ^ Not Applicable Name:_ Address: City: — Zip: Phone FEE SIMPLE TITLE HOLDER: Name: Address: City: Zip: Phone: State Not Applicable MORTGAGE COMPANY Name: Address: City: Zip: Phone. BONDING COMPANY: Name: Address: City: Zip: Phone: Not Applicable State: Not Applicable 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF 5. L,�.�zsL� COUNTY OF The for oing instrument was acknowledged before me The forgoing instrument was acknowledged before me this day of 20ffl by this _ day of 20 L1 by Name of person making statement. Name of person making statement. Personally Known OR Produced Identification f/ Personally Known OR Produced Identification Type of Identification Type of Identification Produced k__ Produced Signature of Notary Pub State of Florida ignature of Notary Public- State of Florida ) Commission No. (Seal) ,0` mmission No. Seal cn �d REVIEWS FRONT ZONING SUP Tc 3 m 9(Jff--Di m LAMS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW RE y.om VIEW REVIEW REVIEW REVIEW DATE RECEIVED rn o z DATE o rn d COMPLETED Nv co� Rev. L///ly ST.LUWP V 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 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. A07— 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 codes, and zoning regulations. Initial Here. M� I understand that the building official and inspectors are not there to design or give advice on how to meet 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. Initial Here. A-.-C 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 the license. Initial Here. A.,L 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, which 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 Buildi g Department to the Florida State Department of Professional Regulation. Signed knowledge o� day of M4-.-c 1. of 20 7-1 . ,( a Owner/Builder Signature STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this % day of 20 by who is personally known to me, or, produced L as identification. Signature of Notary Type or Print Name of Notary Title: Notary Public Commission Number �o .c3MM -n.30> ?0 y T= e3 <N.�N.om aX ow * T W o,OC)oC or"�2'T x OD,< O m j c N Q Q V _. X WATER COMM SEWER RES METER SZ. M/F IRR $ SECURITY DEP SERVICE FEE SAME DAY FEE OVERTIME FEE 25�4 METER INSTAL CFC/WATER FPUA CFC CFC/SEWER GUAR. REV. LATERAL $ �j( TOTAL CUSTOMER SIGNATURE ST. LUCIE COUNTY UTILITIES - P.O. BOX 728, FT. PIERCE, FL NAME Michael Knauer ACCT. # eX' 0?/'� _ -I r �6 SERVICE ADDRESS 5910 Raintree Trail Fort Pierce FI 34982 SUBDIVISION LOT BILLING ADDRESS 5910 Raintree Trail Ft Pierce FI 34982 EMAIL ADDRESS: uSer2543@gmall.com PHONE # 772-333-7675 MOVE IN/CLOSING C This application hereby request and authorizes the Utility to render wi services to the premises described above in accordance with the Utiliti rules and regulations, which by reference are made a part of this contr Utility promptly for such services in accordance with the established rr. CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE. SOCIAL SEC/FED ID 385-94-4072 NAME OF SPOUSE Jan Mishler SPOUSE SOCIAL SEC. 189-70-2014 OFFICE USE ONLY ST LUCIE UTILITIES DEP 2300 VIRGINA AVE FORT PIERCE, FL 34982 (Q;r25!2021 13:04:52 KD; XXXXXXXXkf(XX488 TID:=501 CREDIT CARD VISA SALE (ed a XXXXXXXXXXXX2792 SEQ 5 Eatch u; 1584 INVOICE 5 Efgroval Code 466064 Entry method: Marwal Node: Onire Cdd Code: M SALE AMOUNT $521.25 DATE RECEIVED { CASH CHK # RECEIVED BY I agee to pay above total amount accordN to card issuer agreement. (wchant ageernent 9 Credit Voucher) MERCHANT COPY