No preview available
HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date Permit Number: d(S �O RECEIVED -== Building Permit Application Planning and Development Services APR 2 1 2021 Building and Code Regulation Division Commercial Residential apartment 2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie Courrty Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: Address: R5 O'� S Property Tax lD #: _ 3y 62 - i -DC) y 7 -- O O C) / ,3 Lot No. 3y Site Plan Name: Tnz%'[3n 2sy'wr e.S \akC'_S Block No. 23 Project Name: Qo pka ce bac YeK1C•e_ 1 U� f wl oP- &•S New Electrical Meter Second Electrical Meter 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: :4 81 Cost of Construction: $ `Z 00 Sq. Ft. of First Floor: Utilities: —Sewer.. —Septic Building Height: QW'NER/1110.8EE: C©NTRACTUR: Name S nQ c% Name: Address:45QJ SecanJnQ Company: City. rnY1 2x" e Zip Code: -_i y q' K 2 Fax: Phone No. ISG I S State: EL 9 Address: City: State: Zip Code: Fax: Phone No nnI E-Mail: tiQG l -SPx� 4Ye_S� Q \C%� � ece�� 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 G©NSTRUCTON LIEN LAW 111 80 TIQN: 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 and posted on the jobsite before the first inspection. If you intend to obtain financing, consult wi endear attorney before commencing work or recording your Notice of Commencement. LA, 141-, Sign at r wner/ essee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OFF L(_e� COUNTY OF n to or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization Physical Presence or Online Notarization this day of , 2020 by this day of 2020 by Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identificati Type of Identification Produced ,.��"� , Produced FOF (Signature of Notary Public- to of Florida (Signature of Notary Public- State of Florida ) moo° S Commission No. (Se - �3 o m Commission No. (Seal) a o -i c 3 N o = REVIEWS FRONT ZONING OR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW mmy REVIEW REVIEW REVIEW REVIEW DATE a. w < O RECEIVED N C DATE 0' COMPLETED ev. Planning & Development Services Department COUNTY Building & Code Regulations • R I • A 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 b� county or municipal licensing ordinances. Initial ..� 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 lu0_ 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 I understand that the building official and inspectors are not there to design or give advice on how to � meet � the minimum code. Initial M t 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_ 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 of the license. Initial P— 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 y V To qualify for this exemption under this subsection, an owner must personally appear and 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 XM acknowledged on this 7,1 day of of 20. STATE OF FLORIDAa�% COUNTY OF ` -)^ L LJ The foregoing instrument was acknowledged before me this —Z-4- day of o _ by who is personally known v to me, or who has -„0 3 CD m 0 3 produced p � li as identification. 'r —Di � o3 o• o m �� p�s�, /� h',�' A "�^ G N L 1yi�1�L Signature of Notary Type or Print Name of Notary (Seal) y. Oo N C) o c Title: Notary Public Commission Number N X SLCPDSD Revised 02/7/20 ^J R w O a)NcX