HomeMy WebLinkAboutBuilding Permit package All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: V ( Permit Number:IN
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Building Permit Application JUN 0 3 2021
Planning and Development Services ft.Ludle m I��tmitti
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Building and Code Regulation Division Com
mercial Residential
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR:
PROP0S IMPROV,EIVIENT LOCATIQN
Address:��a � � a C R Y ini4 a �if � /P64 50-i sA �r + p E-�m a
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Property Tax ID#: 3��� 5 -�adl~ �" Lot No:
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION,OF UIIQRK a
sI sA o
New Electrical Meter -Second Electrical Meter (Affidavit required)
CONSTRt1CTIQ IN
b
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: Sq. Ft. of First Floor:
.o
Cost of Construction:$ 6 Utilities: —Sewer _Septic Building Height:
bWNER/,LESSEE CONTRACTOR £
Name� �� f,f,. �� �.. S •e Cam+ F Namey;` F r:
Address:_I-9f QL A-1 e: C-C���' t-,4- Q A Compa,riy:_
City: Po Y4 0J. `A v. ;� State: ',Address:µ V,
Zip Coder C/ � _ Fax: �Lty. ._.x=�::-=.-F:,= . _ State:
T
Phone No.`4 4 'c�5. 0 Zip Code: Fax:
E-Mail: ie G t-4 Q + Phone No
Fill in fee simple Title Holder on next page (if different E-Mail
from the Owner listed above) 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.
5UPPLEII/I ENTAL CONSTRUCTION LIEN LAWN
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLEHOLDER: _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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attorney before commencing work or recording our Notice of Commencement.
Signature o Owner/Lesse ontractor as Agent for Owner
STATE OF FLORIDA
COVNTY OF S-ir . L -3 c'�e
Sworn to(or affirmed) and subscribed before me of Physical Presence or Online Notarization
this-b day of Z y he 20k% by
Name of pe son making statement.
Personally Known OR Pro uced Identification
Type of Identification Produced
(Signature of Notar fblic-State of Florida)
Commission No\N�'0Ae0J-Sq DEANNAGIVEN$
� �I) Notary Pubtic-State of Piorida
Commission'HH 086359.
oFF` My Comm.Expires Jan 28,2025
Bonded through National Notary Assn.
REVIEWS FRONT :ZONING SUPERVISOR PLANS VEGETATION. SEA TURTLE.'.,, MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW ._REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev 5/20/21
t Q Planning&Development Services Department
` . . Building&Code Regulations RECEIVED
. - 2300 Virginia Avenue Fort Pierce,Florida 34982 ,J U N O 202yy1
(772)462-1553
St.Lucie County
OWNERBUILDER AFFIDAVIT DISCLOSURE STATEMENT Permitting
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. F
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. F
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. -F
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. P F1
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 Here. DP
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 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. D-P
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 ackn led g on this
day of�� of 20_U.
OwnerBui der Signature
STATE OF FLORIDA
COUNTY OF --V. L.oe,-Q_-
The foregoing instrument was acknowledged before me this 3 day of 5y� ,200\1 ,
by po� ,�S e t who is personally known to me,or who has
produced V_l, ,n L_ as ident
Y'P�e:.. DEANNA GIVENS
Notary Public-State of Florida
1J ; Commission#HH 086359
Signature of N Type or Print Name of Notary Of sy Comm.(SO)Jan 28,2025
Title:Notary Public Commission Number K" ICS . Banded through National Notary A:sr.
MICHELLE R. MILLER, CLERK OF THE CIRCUIT COURT — SAINT LUCIE. COUNTY
FILE1# 4873016 OR BOOK 4622 PAGE 104, .Recorded 06/03/2021 09:40:10 AM
RECEIVED
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FMIr"4a34 St.Lucie County
Permittinq
REVOCABLE LICENSE AGREEMENT
THIS AGREEMENT, made and entered this I Sir day of 2021,by and
between ST.LUCIE COUNTY.a political subdivision of the State of Florida,("County")and Davli
Fonseca whose address is,192 NE Caprona Avenue,Port Saint Lucie,FL 34983(the"Owner").
WHEREAS,the Owner owns the property described as follows:
River Park Unit 4 Block 42 Lot 10-192 NE Caprona Avenue
Parcel ID:3419-530-0281-000-6
WHEREAS, the Owner has requested a Revocable License Agreement to Install a 6'
Aluminum fence with gates along the sides of the property within the County's 6'
Drainage/Utility Easement and along the rear of the property within the County's 10'
Drainage/Utility Easement as shown on Exhibit A.
WHEREAS, the County is willing to permit the Owner to encroach in the County's
easements for the purpose of installing a fence subject to the terms and conditions set forth in
this Revocable license Agreement
NOW, THEREFORE, in consideration-of the mutual covenants set forth herein, the
parties agree as follows:
1. The County agrees to grant the,Owner a Revocable License Agreement for the
fence which will encroach within the County's Easements._This Revocable License shall extend
only to the referenced fence and shall not extend to the construction and/or installation-of any
additional structures or utilities.
2. The sole purpose of this Revocable license Agreement Is to grant the Owner
permission to install and maintain the fence in the County's easements. The Owners agree that
if the County Engineer determine the fence is causing flooding,drainage problems or for other
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OR BOOK 4622 PAGE 105
needs in the area and the fence needs to be removed or relocated,the Owner will do so at the
Owner's sole expense.
3. Pursuant to the terms and conditions contained in this Agreement,the County
authorizes the Owner to install the fence in the County's easements. The applicant shall obtain
a St.Lucie County Building permit prior to the commencement of construction activities within
the County Easements.
4. The Owner shall maintain the easements along the fence in accordance with
Standard Specifications for Public Works Construction in St. Lucie County, Florida. The fence
shall not interfere with County use of the easements and any damage to the County easements
shall be repaired by'Owner.
S. This Revocable License Agreement shall be binding on future successors and
assignees of the Owner,provided that the Owner give adequate notice to the County pursuant
to Paragraph Twelve(22)of this Agreement.
6. The County shall have the right,at the sole discretion of the County Engineer,to
terminate this Agreement with or without cause and require removal of the encroachment at
the Owner's sole expense upon ninety(90) days written notice to the Owner. The County
Engineer in lieu of termination may request that the Owner perform certain alterations to the
i
fence or the location of the fence,at the Owners'sole expense. However,If such alteration is
not performed to the satisfaction of the County Engineer the County shall be entitled to
exercise its right to terminate this Agreement.
7. Upon the abandonment of the fence, the expiration of this Revocable License
Agreement,or the revocation of this Revocable License Agreement,whichever occurs first,the
Owner shall be responsible for the removal of the fence and repair of the easements, if
necessary.
8. The term of this Revocable License Agreement shall begin on the date first above
written and shall remain In effect unless otherwise revoked or abandoned as provided herein.
9. Owner agrees to relocate the referenced fence,at any time and at no cost to the
County,if necessary,for the maintenance or improvements of the easements by the County or .
Utilities Deptepartrnent. The County does not accept any responsibility for damages to the fence
to be able to access the easements.
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OR:BOOK 4622 PAGE 106
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10. The fence shall be,installed in accordance with all applicable building codes and
permitting regulations of the County and shall be maintained.solely at the expense of the
Owners. Any maintenance or relocation activity will be subject to the written approval of the
County Engineer.
1L The Owner agrees to allow County employees access to the location of the fence
for County purposes as determined by the County Engineer.
12. All notices,request and other communications dealing directly or indirectly with
this License shall be in writing and shall be(as elected by the person giving such notice)hand
delivered by,messenger or carrier service,telecommunicated;or mailed by registered or certified
mail(postage prepaid)return receipt requested,address to:
As to County: With Copies to: .
County Engineer County Attorney
Engineering Dibision 230.0 Virginia Avenue,3rd Floor
2300 Virginia Avenue,2nd Floor Fort Pierce,FL 34982
Fort Pierce,FL 34982 -
As to Owners:
Dayli Fonseca
192 ME Capron Avenue
Port Saint Lucie,FL34983
or to such other address as•any party may designate by notice complying with the terms of this
section. Each such notice shall be deemed delivered (a)on the date delivered if by personal
delivery, (b)on the-date upon which the return receipt is signed or delivery is refused or the
,notice is designated by the postal authorities as not deliverable,as the case may be,if mailed.
13. As consideration for the County granting this Revocable License Agreement the
Owner agrees to indemnify and hold the County harmless from and against all claims,liability,
demands, damages, expenses, fees; fines penalties, suits, proceedings, actions-and costs of . :•
actions,including reasonable.attorneys fees of any kind or nature arising or in any way connected
with the use,occupation,management,or control of the above property by County o�its'agents,
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OR BOOK 4622 PAGE 107
servants,employees,patrons,or invitees,or resulting in injury to persons or property,or loss of
life or property of any kind or nature whatsoever, sustained during Licensee's use of the
property.
14.f The Owner shall promptly pay to record this Revocable License Agreement in the
Official Records of St.Lude County,Florida. The Owner shall pay any document excise taxes and
the cost of recording this-Revocable.License Agreement.
IN WITNESS WHEREOF,the parties have executed this Agreement on the day and year
above first written.
A ST: ST,
LUCIE COUNTY
BOARD OF COUNTY COMMISSIONERS
DEPUTY CLERK
J�tY COIj BY:
HAIR
am
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APPROVED AS TO FORM AND
CORRECTNESS: '
COUNTY O EY
4
V
OR BOOK 4622 PAGE 108
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Witness ! �-
A�NfoN/ /yA/jECJ� Dagli Fonseca
PRINT NA
Witness
PRINT NAME
STATE OF FLORIDA
COUNTY OF Sr.LUCIE
The foregoing instrument was acknowledged before me by means ofXphysical presence or(]
online notarization,this $'of Jq 'j l(dateft Qaxli Fonseca .who is personally known to
me or who has produced F�L -FLWc-Wfv-796— (type of identification) as
Identification.
(Notary Seal] ,v JW,UASCM Xftt�aryatureSign
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St.Lucie County
Permitting
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