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Home My WebLink AboutBuilding Permit All APPLICABLEN MUST BE COMPLETED PP CATION TO BE ACCEPTED INFOFOR APPLICATION Date: Permit Number: Z�� O 7o,3 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 Residential PERMIT TYPE: Address: ZZ 3 12a%-c��D �r��v�{Fi�� i��cc l'G >'�/��z- Property Tax ID #: Lot No. Site Plan Name: Block No. Project Name: PAM 0" WN a y —�u _ s s- tea. 15I 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: $ f 2Sr Utilities: —Sewer _Septic Building Height: -R ..v�...s ....._a z.z 3,+`�:. a cd -7S' MONSOON" vu-�a' yam' _ `',_ yea, -: _ �.,', �' w, �k -AN-€' -s... +� Name G 9�,i /-��,�'1%;n Name: I Address: -:Company: City: ��-,/��.-:may 7�•"' - State:_ Address:`. Zip Code: 3z",?r-L Fax: City: ' State: Phone No. 772- 5'0 Y -07fr3 Zip Code'" Fax: E-Mail: Phone'Nb,7- ; Fill in fee simple Title Hoider on next page( if different E-Mail from the Owner listed above) State or County License If value of constructi,pn is,$2500 or.410 e;_a.RECORDED Notice of Commencement is required. if value of HVAC is$7,500 oe more;a.RECbRDED 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 YOU12 PAYING TWICE FOR IMPROYEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORIDED 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." Si atur n , see/Contractor as Agent for Owner Signature of Contractor/License Holder ATE OF FLORIDA STATE OF FLORIDA COUNTY OF 2> — t ,,.tom COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this Z day of 44,C.A 20�Z4, by this_day of 20_ by Name of p rson making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced (Signature of Nota Public-State of Florida) (Signature of Notary Public-State of Florida ) Commission No. bi d S� {�NNAGtV-"'t`iO��a ( vu4lic-Staten Commission No. (Seal) N0 commission r HH 086�359e25 c ires Bar tti.' �0ogh Nations.No REVIEWS FRONT ZO RVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNT IEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED I ev. 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 county or municipal licensing ordinances. Initial Here. 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 Her 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 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 - 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 Her 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 license. Initial Her 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 whi 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 Building and Zoning Department to the Florida State Department of Professional Regulation. Signed and acknowledged on this A(niwi day of 2.3.4 of 20 erBuilder Signature STATE OF FLORIDA COUNTY OF Sk_ \..), The foregoing instrument was acknowledged before me this 21 day of A �;; 1 ,20_;k�, by who is personally known to produced L. as identifica n, . � DEANhA GIVENS c� e Notary ocbiic State of Florida Yv� G If2M Commission=HH086359 Signature of Not a Type or Print Name of NotaryP�O My Co�m�m�,,.tExpires Jan z8,zoz5 Title:Notary Public Commission Number Bonded thEeugw�ationai rotary assn. 1-��o�G3S ST LUCIE CEP 2300%RGINA AVE,. FORT PIERCE,:F04982,. 03/231'2021 12:19:26 ,6 COMM ST. LUCIE COUNTY UTILITIES - P.O. BOX 728, FT PIERCE, FL 34982 CREDIT CARD X RES NAMEGary Franklin VISA SALE / Q`/� �1 card# XXIO(XXXXXIU(X7,,098, g M/F . ACCT.# ! —4`, Chip Card: VISA DEBIT RdD: A0000000631010 I IRR `'EQ#: 1602, _SECURITY DEP SERVICE ADDRESS5223 Palmetto Drive, Fort Pierce Florida 34983 Eatch�: INVOICE 8 SERVICE FEE R,pproval Code: Cho '� — Entry Method: Chip Read _SAME DAY FEE Indian River Estates 46,47,48,49,50 ISSUer SUBDIVISION LOT BLOCK05 Mode: _OVERTIME FEE ►�LE AMOUNT �521,25 SALE " c METER INSTAL BILLING ADDRESS5223 Palmetto Drive, Fort Pierce Florida 34983 _ CFC/WATER EMAIL ADDRESS:grfranklinir@gmail.com CUSTOMER COPY FPUA CFC 772-528-2783 10/9/2020 - PHONE# MOVE IN/CLOSING DATE CFC/SEWER GUAR. REV. This application hereby request and authorizes the Utility to render water and/or sewage disposal services to the premises described above in accordance with the Utilities present or future rates, LATERAL rules and regulations, which by reference are made a part of this contract.Applicant agrees to pay $ 519 TOTAL Utility promptly for such services in accordance with the established rules and regulations. CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE. CUSTOMER SIGNATURE SOCIAL SEC/FED ID 594-92-2977 NAME OF SPOUSEAshley Franklin SPOUSE SOCIAL SEC.593-98-1 884 OFFICE USE ONLY DATE RECEIVED CASH �— CHK# RECEIVED BY./�\�► '' 11r5�.