HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
RCCEIVED
CIL
JUN 18 2021
• v g Application Permitting Building Permit A lication
St. Lucie County
Planning and Development Services
c/
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: _5OZ�i (PLC O ekN)E— CPiE-r
Property Tax ID #: ' t �30 " �� C1 — OOO Lot No.y �_
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
P �IIV - L-J 1 T H NE -.J C V r'—_ J
New Electrical Electrical Me er Second Electrical Meter
CONSTRUCTION INFORMATION:
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:
Cost of Construction: $ I (j(J Utilities: —Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR: -
Name
Name:
a
Address:PAt_c�_ C"12w1z
Company:
City: C_'[- iPIE2e(_ State:
Address:
Zip Code: '3 -96 Fax:
---
City: State:
Phone No.1 6k+ 01,--30
Zip Code: Fax:
E-Mail: Clnns 9-0 :7 6 q9 �mcx.l ''�
Phone No
Fill in fee simple Title Holder on next page ( if different
E-Mail
State or County License
from the Owner listed above)
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.
66,
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: Not Applicable
Name: C-44e1.5 C3h---- CX
_
Name: 3 C S 2��c,Qc>�icct
Address: Sw 6" AVE
Address: 49- W►ertnc: Sk
City: f�-_ State: FL.-
City: �, sic A� State: N
Zip: Phone 51.1 L os3
Zip: 1o\o hone: q14 4ITt-t �64-
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: of Applicable
_
Name: C-Q C Cann kkxre-S 1.1;L
_
Name:
AddressF1(6+ I1CA3 P5L-Sw0
Address:
City: PSG
City:
Zip: 34q 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_aaattornev before commencing work or recording your Notice of Commencement.
Sig re of Owner/ Les6go<ontractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF
Sworn r affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
hysical 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 Identification
Type of Identification
Produced ✓ `","'
Produced
C�
''
(Signature of Notary Public- St e of Florida) ;,y
(Signature of Notary Public- State of Florida )
Commission No. (Seal) 3 cDm
Commission No. (Seal)
cDQ3a>
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3 y T 2
REVIEWS
FRONT
ZONING
d aim
S 4744'
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
itm C
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
Nix -n
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DATE
y 0
COMPLETED
ev.
MICHELLE R. MILLER, CLERK OF THE CIRCUIT COURT -- SAINT LUCIE COUNTY
FILE # 4878021 OR BOOK 4628 PAGE 1463, Recorded 06/11/2021 09:43:30 AM Doc
Tax: $1557.50
This Instrument Prepared by and Return to-
DEBORAH A. CARMAN, ESQ.
PALM TITLE SERVICES, INC.
5301 N. FEDERAL HIGHWAY, # 160
BOCA RATON, FL. 33487
Our File No.; 21-186
Property Appraisers Parcel Identification (Polio) Number: 1312-801-0090-00017
Florida Documentary Stamps in the amount of S1,557.50 have been paid hereon
Space above this line tnr Recording
THIS WARRANTY DEED, made the 10th day of June, 2021 by GARY LEWIS BURNS, 3R. and HEATHER
BURNS, HUSBAND AND WIFE, whose post office address is 9331 BREAKERS ROW, FORT PIERCE, FL
34945 heroin called the Gtamtors, to C & C CUSTOM. HOMES LLC, A FLORIDA LIMITED LIABILITY
COMPANY whose post office address is 1193 SE PORT ST. LUCIE BLVD. # 167, PORT SAINT LUCIE, FL.
34952, hereinafter called the Grantee:
(Wherever used herein the terms "Grantor" and "Grantee" include all the parties to this instrument and the heirs, legal
representatives and assigns of individuals, and the successors anti assigns of corporations}
W I T N E S S E T H: That the Grantors, for and in consideration of the sum of TEN AND 001100'S ($10.00) and
other valuable considerations, receipt whereof is hereby acknowledged, hereby grants, bargains, sells, aliens, remises,
releases, conveys and confirms unto the Grantee all that certain land situate in ST LUCIF. County, State of Florida,
viz.:
Lot 287, HOLIDAY PINES PRASE I1B, according to the map or plat thereof, as recorded In Plat Book
20, Page(s)12, of the Public Records of St. Lucie County, Florida.
Subject to casements, restrictions and reservations of record and taxes for the year 2021 and thereafter.
TOGETHER, with all the tenements, hereditaments and appurtenances thereto belonging or in anywise appertaining.
TO HAVE AND TO HOLD, the same in fee simple forever.
AND, the Grantors hereby covenant with said Grantee that the Grantors lawfully seized of said land in fee simple;
that the Grantors have good right and lawful authority to sell and convey said laud, and hereby warrant the title to said
land and will defend the same against the lawful claims of all persons whomsoever; and that said land is free of all
encumbrances, except taxes accruing subsequent to December 31, 2020.
File Nn : 21-196
LT?
Warranty .Deed
Page 2 of 2
IN WITNESS WHEREOF, the said Grantors have signed and sealed these presents the day and year first above
written.
Signed, sealed and delivered in the presence of:
C.�y6llti �c -�,�
Witness #1 Signature
Wi s #1 ted Name
Witness 1 Signature
Witness #2 Punted Name
State of Florida
County of St. Lucie
(Seal)
fii�fCRY L)>�WIS BURNS, JR.
_Aty/ - (Seal)
HEATHER BURNS
The foregoing instrument was acknowledged before me this day of June, 2021, by GARY LEWIS BURNS,
JR and HEATHER BURNS who appeared by ® physical presence or ❑ online notarisation and have produced
N- N-%L -1 G: ter. as identification.
SEAL
My Commission Expires: p5�j4�2�
* ,► ba#HN1311$3
moo` fthM M&Y 10, 2025
Notary Public
t�-U 12�
Printed Notary Name
He No.: 21-186
4 S15u,
o
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 tp 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./7(l
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.
(—Y
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.
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. Co
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. 63
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 owledged n this
day of � e of 20;-7-(.
OwnerlBuilder Signature • 46"
STATE OF FLORIDA �a
COUNTY OF S]t-- L�tFC.J`-f
The foregoing instrument was acknowledged before me this day of J- 20
by who is personally known to me, or whb has T 3° (b m
produced as identification. 9 ry 3 D
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Signature of Notary Type or Print Name of Notary (Seal) rn o T. C) Z
Title: Notary Public Commission Number oN $ G) 0 C:
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