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HomeMy WebLinkAboutBuilding Permit Package IF All APPLICABLE INFO MUST BE MPLETED FOR APPLICATION TO BE ACCEPT Date: p' Q'1 Permit Number: �o Im N Li LARAMI-AMFIff 2 Building Permit Application RECEIVED Planning and Development Services MAR 0 8 2021 Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Permitting Department Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential s . 'uc;e'unt" PERMIT TYPE: - 69 ` _- � ._ .. - ° e 'y.` a" '.z-�< - s - :: w.��g y- R `_ •'ems Address _s .4ffil v.�_ ©�>;fnYa u�� , C,14 4PIe-VNC-A2- , R Property Tax ID #: ( � u^ Q0;o— 0L90 Lot No. Site Plan Name: Block No. Project Name: -�'�. �.•- -� „� --_-w--s eke'fi �-=.'y` :. i � "' - --x.ti*.� '� ^5,�€N �--�, r -c ^ y '3�' Puy P6 S-e- t].0 Additional work to be performed under this permit-check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Electric _Plumbing _Sprinklers _Generator _Roof. Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ i]0 Utilities: —Sewer _Septic Building Height: s ,,,. - �--"� Yi y" ... 3 -�3"'£e.r, `ems^1 .,: `i - 'V; �F 'g'- 3- EIr �77 �L s r z a yeaY' c�� a4 � � rt c`s 9 x.. .•+w,. �,m�a5 av�� a(�"a'zi � Name ®I�ttI�W�YN-Pitt �Y��11- Name: Address: QT14 ®fAw if—e— Company- . City: el-Q:r State:�i- Address: Zip Code: �j �e" Fax: City: State: Phone No. 2ZJ !'Q-2- 3 Zip Code: Fax: E-Mail: 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 HVAC is$7,500 or more,a RECORDED Notice of Commencement is required. A 0-m-m-N 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RE CORDING YOUR NOTICE OF COMMENCEMENT. ,Signatu"re of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF �i1�-1 CIc � COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this f�-day of ft:I_,20 -qA by this_day of 20_ by Name of person making statement. / Name of person making statement. Personally Known OR Produced Identification ✓ Personally Known OR Produced Identification Type of Identification Type of Identification Produced N Produced I (Signature of Notary Pub'c ignature of Notary Public-State of Florida ) KAF;EN S. NIELSEN Commission No. osPa °B�;Stat(ES@ I�iorida-Notary Publ c mmission No. (Seal) -. *_ Commission # GG 207 8 9 oP< My Commission Expires REVIEWS FROM ING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. `t j p Tanning&Development Services Department • o N N uilding&Code Regulations �., RECEIVED 2300 Virginia Avenue Fort Pierce,Florida 34982 (772)462-1553 MAR 0 8 2021 OWNER/BUILDER AFFIDAVIT DISCLOSURE STATEMENT permitting Department F.S.489.103(7)EXEMPTIONS St. Lucie Count• 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 $75,000.00 as long as it is for your own use or occupancy.You may not build or improve said structures for the purposes of selling or leasing that building. You may not hire an unlicensed person to act as your contractor or to supervise people working on your building; it is your responsibility to make sure that people employed by you have licenses required by state law and by county or municipal licensing ordinances. InMlH� e. If you sell or lease a building you have built or improved within one year after construction is complete, then a presumption is created that it was built or improved for sale or lease,which is a violation of this exemption. Initi erg} You may not delegate the responsibility for supervising work to a licensed contractor who is not licen ed to perform the work being done. Your construction must comply with all applicable laws, ordinances, building codes, and zoning regulations. InitiaJYJ l ere- I understand that the buildingofficial and inspectors are not there to design or give advice on to'mebt the P minimum code. Initial I e e. a contract dis utes with sub-contractors and I must be h$ d dVOcivil I understand that as an owner builder that ny p court with the advice of an attorney. This department will not mitigate any contract disputes. Initial a e. �A P I understand that if I compensate any person or company for work performed they are required to be ice s d 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. kyt t' an erson that is unlicensed and uninsured ets injured on my construction projectkt e I understand the if y p g J 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 Ire To qualify for this exemption under this subsection, an owner must personally appear, sign the bin 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 ZonI g Department to th Florida State Department of Professional Regulation. Signed and acknowledged o i t is_T day of Y of 20�. M 0 "A fl Owner/Builder Signature STATE OF FLO !A _u_Q COUNTY OF The foregoing ins ent w acknowledged before me this A_day of ,20oZ , by who is personally known to me,or who has produced as identification. Signature ofNota Pe of Notary (Seal) Title:Not Publi aa�,, KAREN SC N her ;_ ;State of Florida-Notary _* Commission # GG 207484 -.,9rF ,° My Commission Expires June 12, 2022 r I - .. -;+�: ,.,.,.ems • .��...,.�.:,.r.Fe - 3 r. � r..�`.F 3 =.. ��y 'I�� � _ .. _. •I j � b l*.. �.5�.Fes!: _ •f r.' .Y iry•... � .w. • •I• t� - S ^�'„-�° _ '1 • I • ; h I 1 � 4. EE" ' A bCANIa i• , ' 1 PermittingD