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Home My WebLink AboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED n Date: DA Permit Number: � �►1`C ;�Iir. L-WHE p f RECEM: e Building Permit Application JUN 17 2021 Planning and Development services Building and Code Regulation Division Commercial Residential St.LucieCqmv 2300 Virginia Avenue, Fort Pierce FL 34982 Phone:(772)462-1553 Fax: (772)462-1578 PERMIT APPLICATION FOR: Address: SqIjP2 D r UP— 17' el^c-e— FL 52-- Property Tax ID#: Lot No. Site Plan Name: Block No. Project Name: hook u..�-� ��y I✓i9a i� 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: Sq. Ft. of First Floor: Cost of Construction: $ Sa11. Utilities: _Sewer _Septic Building Height: Name evl 'vVl K4 0V7 15 Name:- Address: 5`�/�( 'I«]e�,re (fir Company: City:_r��/et State:F-L= .'Address:. Zip Code: �Y9�`2— Fax: City: State: Phone No. 772- 52'K- 7Z7 ( Zip Code: Fax: E-Mail: (2A ket-WeyX ID !IMq C-00 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. i 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 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 of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF ` —wC"C' COUNTY OF Swgr'n to(or affirmed) and subscribed before me of Sworn to(or affirmed)and subscribed before me of Physical Prese ce or Online Notarization Physical Presence or Online Notarization this-q day of U N) - 2024 by this day of 2020 by P�Q116 L i ya"0 ns Name of person making statement. / Name of person making statement. Personally Known OR Produced Identification ! Personally Known OR Produced Identification Type of Identifica+or Type of Identification Produced Produced A A ---�� (Signature of Notary Pub - EN S. NIELSEN ignature of Notary Public-State of Florida ) n i u,, `1f,PY PUB�i Commission No. =*� `R=Stat�of Mrida-Notary Public ,� oc Co- 1il sion # GG 20748 mmission No. (Seal) My Commission Expires June 12, 2022 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 5/6/20 Q Planning&Development Services Department RECEIVED • o Building&Code Regulations _= .=_._...,_-.<.a_ =.•_ " 2300 Virginia Avenue Fort Pierce,Florida34982 JUN 17 2021 (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 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 Her 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. 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 Departrqent to the Florida State Department of Professional Regulation. Signed and acknowledged on this day of of 20c9\ OwnerBuilder Signature STATE OF FLO COUNTY OF \ Th egoing ins ment was ack�wledged before me this_a_day of J l} _, ,20�L, by ` 't NDAMnk) who is personally known to me,or who has produce as identification. Signature of Notary Type�orPrint Name of Notary (Seal) Title:Notary Public Commission Number � y pV l� KAREN S. NIELSEN ��:State of Florida-Notary Public =• Commission # GG 207484 My Commission Expires � un!"' June 12, 2022 ST LUCIE COUNTY UTILITIES P O'BOX 728,PT PIERCE,FL 34982 r YNAME �Jf l�r lnl� Y - St. Lucie Count - PUTIL 06-17-2021 �9:39:11 �►CCT # �F f i C1� " 21077/4837 E SERVICE'ADDRESS 1 W, FORTDPINCEENA 34982 Amount Tendered: 521 .25 ( SUBDMSION l-` Y LOT_ BLOCK Amount Paid: 521 .25 BILLING ADDRESS a's r. - i Change Due: 0.00 Thank You User ID: MURRAYA il =, This apphcatrion hereby request and authorizes the Utility to render water and/or sewage disposal services to the premises described above�n accordance with the Utihries present or future rates, �Til�"At: rrfi� fi - rules and egulaho"'ns,which by reference are made apart of this contract Applicant agrees to:pay v� the Utility promptly for such services m accordance with the estaliLshed rules and;regulations:. TAL _ CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE CUSTOMER COPY _ SOCIAI.SEG/ FEl2ID NAME OF SPOUSE SPOUSE SOCIAL.SEC _ OFFICE USE ONLY _DATE RECEIVED CASH �' t RECEIVED BY_j RECEIVED JUN 17 2021 St,Lucie County i'ermittinq