The URL can be used to link to this page

Home My WebLink AboutBuilding Permit All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: yD 7- 7-�7 -- _ - Building Permit Application Planning and Development Services 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: Property Tax ID#: Lot No. Site Plan Name: Block No. Project Name: �91 Gi66 1►' q J {_.r+�'L r[ r . ftfy-sY, (r t t. 4 . ? .� '?'92,+-h �'. r1,�cS. ir-. "+' z,•.k. ' X :.:, r [ } � '?tyle-tk' Y `.Jo New electrical Meter Second Electrical Meter S 2 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: $_Rr o. oo Utilities: _Sewer _Septic . Building Height: � r Name 12 Name: - Address: /0 r ►r t /z �ALj Company: City: ')5 C_ State: Address:, Zip Code:.'y y S Z Fax: City: State: Phone No. 77 L —3Y( A SS Zip Code: Fax:. E-Mail: /� tLf S • C 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. 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'C unty and posted on the jobsite.before the first inspection.If you intend to obtain financing, consult 'w e' er or an attorneybefore commencingwork/_or recordingv rs our Notice of Commencement- r, -2 �Sc��l'��_� W. (� Y� L LD 0 - 2-ror 20 Signature of Owner/ ssee/Contractor as Agent for Owner Signature of Contractor/License Holder . STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of Physical Pr nce or Online Notarization Physical Presence or Online Notarization this 8 day of 20_p!)I)by this day of 20_ by S Name of pe on making stateme t. Name of.persori making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced (Signature of Notary (Signature of Notary Public-State of Florida) q.• •sib I LASHAHNAINGRAM-RAHMING 3* MyCOM �Jd#GG275060 Commission No. (Seal) �: S: OCZ er20 2022 Commission No. EXPIRE BWed Thr rNo tary Public undervaiiAre REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. h O Planning&Development Services Department • ° _ Building&Code Regulations 2300 Virginia Avenue Fort Pierce,Florida 34982 (772)462-1553 OWNER/BUILDER 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 cpufity or municipal licensing ordinances. r� Initial Here. If you sell or lease a building you have built or improved within one year after construction is complete t erg a presumption is created that it was built or improved for sale or lease,which is a violation of this exemption. (//n 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 co e f zoning regulations. Initial Here VV I understand that the building official and inspectors are not there to design or give advice on how to e t minimum code. Initial Here I understand that as an owner-builder that any contract disputes with sub-contractors and I must be handled in a iyil court with the advice of an attorney. This department will not mitigate any contract disputes. �J/n Initial Here. I understand that if I compensate any person or company for work performed they are required to be licensed in Jhis jurisdiction. If for some reason they do not possess a license, I may be responsible and liable for the cos o t f) license. Initial Her I understand that if any person that is unlicensed and uninsured gets injured on my construction project-the y be entitled to workmen's compensation. I could be held liable for all doctor, lawyer and related medical co 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 reporte y e Building d Zonin Department to the Florida State Department of Professional Regulation. Si ac o dged n this day of/904je.4. of 20-Zf. O uilder Signature STATE OF FLORIDA COUNTY OF 54- Lue bf The foregoing instrument was acknowledged before me this I,, day of fVV4 t ,20 , by who is personally known to me,or who has produced p L, as identification. Signature of Notary VType or Print Name of Notary ,�aa�Pam., H E 4TH9 R B U R F O R D ;`e° ��' Title:Notary Public Commission Number =, ,:State of Florida-Notary Public Commission #GG 183217 My Commission Expires February 06, 2022