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Home My WebLink AboutBuilding PermitAll APPLICABLE INFO MUST CBE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: "J �/ V_ C)v�;11 / Permit Number: n�urio� :;pn� •;5 auawped-a 6u1JalwJ^J Building Permit Application V01 t I add Planning and Development Services 43AI3J3?! Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential ERMIT TYPE:�C"e__ MUM F�� _.. r 3- -_(� ,.. _ _ : ,4 _ OW me:µ iracc• Property Tax ID #: Site Plan Name: Project Name: 601, a&' 39 - ow Lot No. Block No. s4, � sF ` v � �e �j - ,p =• #'�WOR, 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: $ W Utilities: _ Sewer ` Septic Building Height: 000017 IxName y` ct— Name: Address: 'G�,/'31 et+�i i vl Company: i City: 1 �.T'C1' Stater! Address: City: State: Zip Code: , L Fax: 1 Phone No. `'%T7 2— - S S! ~ c) Zip Code: Fax: Phone No E-Mail: 6-y) (D Fill in fee simple Ti le Holder on next page ( if different E-Mail from the Owner listed above) i State or County License If value of construction is 52500 or more, a RECORDED Notice of Commencement is requirea. If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required. ry M 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 WIT1--YoQR, LENDER OR AN RNEY EFORE RECORDING YOUR NOTICE OF COMMENCEMENT." I i ure of 0 er/ Lessee Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF L,�1L�� COUNTY OF The forgping instrument was acknowledged before me The forgoing instrument was acknowledged before me this R day of 2� 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 Identificatigv�� Type of Identification Produced ,P Produced (Signature of Notary Public too Florida) 5 ry �O P� (Signature of Notary Public- State of Florida } Commission No. Seal (Seal) = o m; „m Commission No. (Seal) REVIEWS FRONT ZONING S/+ 1Jm PLANS I VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW I REVIEW REVIEW REVIEW DATE RECEIVED ,� m rno csZC DATE ^> m COMPLETED NX, w` oil ev. N , n O Planning & Development Services Department • Building & Code Regulations 2300 Virginia Avenue 14unoD alonj ,s Fort Pierce, Florida 34982 auawliedca 6J133!WJLhJ (772)462-1553 OWNER/BUILDER AFFIDAVIT DISCLOSURE STATEMENT uoa f I adv F.S. 489.103 (7) EXEMPTIONS CGA12D321 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 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, 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 the work being done. Your construction must comply with all applicable laws, ordinances, building s, zoning regulations. Initial Her I understand that the building official and inspectors are not there to design or give advice on how to t e minimum code. Initial Here I understand that as an owner -builder that any contract disputes with sub -contractors and I must be handled in 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 jurisdiction. If for some reason they do not possess a license, I may be responsible and liable for the c o license. Initial Her I understand that if any person that is unlicensed and uninsured gets injured on my construction project -the y e entitled to workmen's compensation. I could be held liable for all doctor, lawyer and related medical hi could include loss of wages during recovery from their injury. Initial He 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. SOed and acknowledyd7n this ,.Z day of of 20 11.�. OwnerB uilder Signature �ALS""'% STATE OF FLORIDA y COUNTY OF ,lj� ,�,�,(r,J� The foregoing instrument was acknowledged before me this �day of 20' C �$ by who is personally known to me, or who has �o ` 3 m produced f 4—as identification. ao m3o.o2 Signature of Notary Type or Tint Name of Notary (Seal) o y Title: Notary Public Commission Number o �o C ti OX �v N(.� �O