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Home My WebLink AboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: i Application Building Permit 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 l/ PERMIT TYPE Kam- _WN Address: '5801 7712i V)G' 2J Ib b( C 3 d l )O - v0U I Lot No. J Property Tax ID #: �t V Site Plan Name: Block No. Project Name FS,w ry .tc--€ _ ST .`a _rT.51 S'E? b^'�,,„e �� ', Y" •� ,S'a z' 't P '�i'a i _ c Y' v y+^ �, Z. .y �ia..3Pu ;� cy,�� - =-'I: .-F'"� ykC• "��TTU.'G. r..' +�. �`?+..�4� :� �. � _ P.� � T � _i< ♦-z-�' .i+. n_,iS--i-L }3=�._•niss _ ..i".. u...i Gt r m u se- IAdditional 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 Construc AA Sq. Ft. of First Floor: Building Height: Cost of Construction: $ JO Utilities: —Sewer _Septic psi Name r 1 l 4l r 0 ) Name: Address: Qa nee I 0 Company: i City: State. Address: I City: State: Zip Code:5qC1Fax: Phone No.�'�� - ED I � y/�, S �p Zip Code: Fax: E-Mail: ,5S��0 S3i C }Mal I (-CM Phone No Fill in fee simple Title Holder on next page ( if different E-Mail from the Owner listed above) i i 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. DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: Not Applicable Name: _ Name: Address: Address: _ City: State: City: State: Zip: Phone Zip: Phone: rrrCIAAMIr-1T 1-1-. ..-- . _ _L•__LI .I_- .- _1]__1 Planning & Development Services Department •_ _ Building & Code Regulations 2300 Virginia Avenue Fort Pierce, Florida 34982 (772)462-1553 OWNERIBUILDER 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 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 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 oft e 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, which 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, Depart, t to 'he Florida State Department of Professional Regulation. Signed and acknowledged on this dof ay f1 I oft( � j I n 0 9 aY(_/ 411 Owner/Builder Signature STATE OF FLORID COUNTY OF !S4-G1 1,0— The �gFegoing i 9trument w cknowledged before me this � day of 20, by �r �I CCV n t, who is personally known _ / _ to me, or who has 4Ti: d t- t>L, Q as identification. YK b'^ - Notary Public State of Florida Ay t �, � Kimberly S SOsphans otary Type or Print Nahie of Nq ; ) My Commission HH 10W6WW otaryPublic Commission Number t {t' ) (Q Q 4 a Expires 03I21I2025 ST LUCIE UTILITIES DEP 238 VM11rAIA AVE FORT PIERCE, FL 34982 COMM 041'0712021 09:08.14 CREDIT CARD RES VISA SALE M/F Card h XXXXXXXXXXXX2000 Chip Card: VISA DEBIT IRR I& A000000O031010 �,EQ 9; 1 SECURITY DEP E&h P. 1613 SERVICE FEE INVOICE I Ipproval Code: 040809 SAME DAY FEE Entry Method: Cho Read Mode: Issuer OVERTIME FEE METER INSTAL SALE AMOUNT $52125 CFC/WATER FPUA CFC CUSTOMER COPY £FC/SEWER GUAR. REV. LATERAL $ 519.00 TOTAL CUSTOMER SIGNATURE ST. LUCIE COUNTY UTILITIES- P.O. BOX 728, FT. PIERCE, FL 34982 NAME Marcelino Garcia ACCT.# J3U SERVICE ADDRESS 5807 Tangelo Drive Fort Pierce , Florida, 34982 SUBDIVISION INDIAN RIVER ESTATES-UNIT-09 LOT 6LOCK LOT 35 76 BILLING ADDRESS 5807 Tangelo Drive Ft.Pierce, FL 34982 EMAILADDRESS: agarcia2711 @hotmaii.com PHONE # 772-801-4156 MOVE IN/CLOSING DATE 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, rules and regulations, which by reference are made a part of this contract. Applicant agrees to pay Utility promptly for such services In accordance with the established .rules and regulations. CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE, SOCIAL SEC/FED ID 59556-9226 NAME OF SPOUSE Angela Garcia SPOUSE 261 SOCIAL SEC. f 5-7244 OFFICE USE ONLY DATE RECEIVED �-� CASH \� CHK #1 RECEIVED BY,