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Home My WebLink AboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �J'f, Date: I - �� SCANNEDPermit Number:v3 '� UILI 0. i Building Permit Application <.ECEIVED Planning and Development Services AR 3 0 I Building and Code Regulation Division Commercial Residential �aa,ent 2300 Virginia Avenue, Fort Pierce FL 34982 S`. _ i ' `-OUP Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: - �r i7C PROPOSED IMPROVEMENT LOCATION: Address: Ty- Fr,f + P, P ✓c'F Property Tax ID #: f �} r% - �/3 - (5626 ` ��(� � Lot No. Site Plan Name: Block No. Project Name: DETAILED DESCRIPTION OF WORK: J / New Electrical Meter Sec d Electrical Meter P °65C � plOIe� a h I;hp CONSTRUCTION INFORMATION: LD S6cck.4Y-, 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: $ / S OO . 00 Utilities: —Sewer —Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name N '>_t+ Name: Address: Z 3 0(' ,� City: r 4 . `( I P /CA Zip Code: 3 �q S / Fax: Phone No. Y'S o - Cola - —� t N l� Cu, t� 1 ,/ • State: t::�- / o5S Company: Address: City: State: Zip Code: Fax: Phone No E-mail: (L V IC+ bo-H 7 / fin' � , ,c'Lj,'� �YiG, Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail 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: Not Applicable Name: MORTGAGE COMPANY: _ Not Applicable Name: Address: Address: City: State: Zip: Phone City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: BONDING COMPANY: Not Applicable 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 attornev before commencing work or recording your Notice of Commencement. Signature of Contracto Signature of Owner/ Lessee/Contractor as Agent for Owner STATE OF FLORID T Cvc' STATE OF FLORIDA L C L COUNTY OF � COUNTY OF Si - / Sworn to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of Presence or Online Notarization --Physical Presence or _,Online Notarization Ph,Ysical this 7 day of _ /Y/� 1,ZC /,t 2020 by this day of ��'� 2020 by r00 1-7-- T� . Name of person making statement. Name of person makin tatement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identific on Produced Produced (Signature of Notary Public- Sta Le of Florida—j-7naof MORIN NotaryPublic- StaROBERT Commission No.� V % � My MMISSION #GG1407 Se PIKES: SEP 04, 2021 n NoGC e Y ° 7 1 ROBERT MORIN ( ' MISSION #GG140780 M"V Bonded through 1st State Insurance EXPIRES SEP 04, 2021 or„f Bonded through tst State Insuranc REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. ILUI LL Planning & Development Services Department P ; , U CA) -- 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 Her If you sell or lease a building you have built or improved within one year after construction is co m , then a presumption is created that it was built or improved for sale or lease, which is a violation of this exemption. Initial Herb. You may not delegate the responsibility for supervising work to a licensed contractor who is not licensed to pe rm the work being done. Your construction must comply with all applicable laws, ordinances, buildi4cs zoning regulations. Initial I understand that the building official and inspectors are not there to design or give advice on ho minimum code. Initial Here. I understand that as an owner -builder that any contract disputes with sub -contractors and I must be handled ' a ' '1 court with the advice of an attorney. This department will not mitigate any contract disputes. Initial H e I understand that if I compensate any person or company for work performed they are required to be lic in this jurisdiction. If for some reason they do not possess a license, I may be responsible and liable for the c t AAf the license. Initial Z6* I understand that if any person that is unlicensed and uninsured gets injured on my construction proj t-the ay be entitled to workmen's compensation. I could be held liable for all doctor, lawyer and related medi 1 g A i could include loss of wages during recovery from their injury. Initial H To qualify for this exemption under this subsection, an owner must personally appear, sign the quildinlpermit 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 to the Florida State Department of Professional Regulation. Signed nd kno ledged on Ws dayof (4ieG, of2021. :>/_/, .L �//l��// Owner/Builder Signature STATE OF FLO�RID COUNTY OF 9` tyC I The fore ng instrum�ef't as acknowledged before me this �� day of �9 dl_c/ , 20_�, by �li-t.' 77 'L� who is personally known to me, or who has produced "_�.Cr✓Ec. y 6 as identification. rd7_ W61 < J kSignature of Notary Type or Print Name of Notary Title: Notary Public Commission Number ROBERTMORIN MY COMMISSION #GG140780 EXPIRES: SEP 04, 2021 Bonded through 1st State Insurance