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HomeMy WebLinkAboutBuilding ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED (� Date: 5- 6-11 Permit Number: a v — 0 r),6' Building Permit Application Planning and Development Services Building and Code Regulation Division Commercial 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: /4uno3 epnj •;S wawlieda,C] 5snplwjed Residential ,,< Vol 5 0 AM 43AI3332i Address: 1 0(-3, l/ 2Dl /" 7 P ' X f- fuL 3 lYl Property Tax ID #: (.� , ,��(7 - (�[� ' �(�(' / Lot No.19_ - Site Plan Name: L/)/i CtV0C) P9>`k �C�C(i �� ' '�, .1. Block No. Project Nome: __ New Electrical Meter Second Electrical Meter Additional work to be performed under this permit - check all that apply: —Mechanical _ Gas Tank , Gas Piping Shutters Electric — Plumbing _ Sprinklers Total Sq. Ft of Construction: _ Generator — Windows/Doors — Pond Sq. Ft. of First Floor: — Roof _ Pitch Cost of Construction: $ & / 1-!^ , Utilities: _ Sewer _ Septic Building Height: Name J1 VJZL/?-1711.704� Address: City:FT, 0i 6,C State: Zip Code:.3 � ' S ' 1 Fax: Phone No, 2� 2� ?%0-©Csl E-Mail: i .i r L'I Fill in fee simple Title Holder on next page ( if different from the Owner listed above) Name: Company: Address: City: Zip Code: Phone No 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. Fax: State: 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 Tf(E JOB, SITE BEFORE THE F!R5T INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH O TTORNEY BEFORE RECOk0iNC rnMlR NOTICE OF COMMENCEMENT." Signature o Owner/ Lesse ractor as ent for Owner Signature of Contractor/License Holder STATE OF LORID STATE OF FLORIDA COUNTY F c%P COUNTY OF The for of g instrument was acknowledged before me The forgoing instrument was acknowledged before me this day of /Y 20�( by this 4 day of 20_ by II �� uS t I lan 17n f Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identificat}OnL / � ' (� Type of Identification Produced U (Signature of N G H N (Signature of Notary Public- State of Florida } `\C4PPY A"B! i State of Florida -Notary Public ,a Commission No. = ,s mmissiol%MP 270079 Commission No. (Seal) My Comr^ission Expires October 22. 2022 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. �i CST LUCn�i_4 oU NT�F L O R I 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. J 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. 7v l 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. _ V Initial Here. I understand that if I compensate any person or company for work performed they are required to be licensed in this 1 jurisdiction. If for some reason they do not possess a license, I may be responsible and liable for the cost of the license. Initial Here. 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 s ent and that i further understand that any violat n of the terms of the owner/builder exemption shall re o Led and Zoning Department a rida State epartment of Professional Regulation S an t� this day of of 20 _, 77A— (lum ar �iilri or Cian�fi STATE OF FLO?A ` (J COUNTY OF J ♦- The foregoing instru'ent as acknowledged before me this 5 day of by Y who is personally known to me or who has pro uced F L n as identification. v ELLEN V `I_State AUGHN Q1of Florida-Notar �"Y! _ Commission q Y Publi Signature of No Type or Print Name of Not '-;; of �) M GG 27007g Title: Notary Public Commission Number """"` YQ ° obe�s� on�Expires