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Home My WebLink AboutBuilding Permit Package All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Permit Number. \G Date: RECEIVED `J 7 NZI C Building Permit Application st.Lucie o Permdtinq Planning and Development Services Residential Building and Code Regulation Division Commercial 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR ti IU _M �[ EY�L �Ire a- ,r ',y �.".` � t y.�'a F�i _ ..-.,.._ —�..k� �� ''F'�� ` �'", �.,y.a 4tF x u�:. "t Address: s a va /v Property Tax ID#: c�` (� ( � L� w� Lot No. Block No. Site Plan Name: Project Name !� � h 1,y Ems^# ��T-��Lf��L��F��4� �+-�" ��j( v1 y 'F'A F. .��ym¢Y 4'� 'T h= t,.. Y � b 't r'�' i a'pY '4-•k w>, r New Electrical Meter nd Electrical Meter (Affidavit required) ' �•' r � 1 � � � � s �� r,r 1.� 1 ,s 5- § �. '''� a� ' SR aY R axe'��x' � M1 z L� ��'�'L �•c:•,.�,��+> � �� r1ST - t�TI tE�� 'A�Ci4t� , Additional work to be performed under this permit-check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors —Pond Generator Roof Pitch _Electric Plumbing _Sprinklers _ — Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ � '� Utilities: _Sewer _� Septic Building He �� L��L�r ? � k+"'y; �.*--�;,,� �s i''�"'�S'�"�,_� rr 4� c��tp-Y�`*�� , l✓.�Y.� �' t�s�� 's � at '`S�y. � �t'„�,s 'ems `^�.T 3x} Name Name: Address: ro _ Company: City: State:��- Address: City: State: Zip Coder Fax: y= Phone No. — , Zip Code: Fax: dry E-Mail: Phone No Fill in fee simple Title Holder on next page (if different E-Mail State or C from the Owner listed above) 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. _,.,...y-�nn:L• .��-r=x..s,.._t ....=- ..c. ^�. ,, —�<..�.z ,' ��^;{,'� -� fix:.. '��?��i€u �yaS�r4s�^..�-��--..�---�'�=-..��--�.�— ;�31 a�'x�5: 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 Build.ing 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 r an attorne before commencing work or recording our Notice of Commencement. C- Signa(te f Owner/Lessee/Contractor as Agent for Owner F FLORIDA _ COUNTY OF Swor to(or affir ed) subscribed before me of y Physical Presence or Online Notarization this day of nd 21]la� by Name of person making statement. / Personally Known OR Produced Identification Type of Identi ' tion Pr duced {Signature of Notary Public-State of Florida ) Commission No. {�AREN S. NIELSEN te of Florida-Notary Public -* Commission # GG 207484 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 .a goPlanning&Development Services Department RECEIVED • • •;r :. - Building&Code Regulations 2300 Virginia Avenue Fort Pierce,Florida34982 JUL ® 7 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.(t�\ 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 i 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, an zoning regulations. Initial Here. I understand that the building official and inspectors are not there to design or give advice on how to Wet the minimum code. Initial Here. A)& I understand that as an owner-builder that any contract disputes with sub-contractors and I must be handled in 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 n 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 iy e 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 buildingeWi ____ P 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. Sjp$d and labmowledged on this day of v � of 20 2.1 j erBuilder Signature STATE OF FLORID_ COUNTY OF ( (S • 1 The for goin instrumen as acknowledged before me this day of ( ,20V, by who is personally known ho me,or who has produced L as identification. Signature of Notary Type or Print Name of Notary (Seal) Title:Notary Public KAREN S. NIELSEN State of Florida-Notary Public =* *_ Commission #GG 207484 My Commission Expires June 12, 2022 ST LUIQjg ppNTY WATER & SEWER DISTRICT (SLCU) NEW CUSTOMER APPLICATION St. Lucie County - PUTIL 07-07-2021 10:08:20 21144/3867 / / ) RECEIVED CARDONA HAROLD FORT PIERCE NAME ' ( (� ( t {'f t�c � n u n 7 292t FL - ACCT.# I 5t.PcCrtnittma34982 n� Amount Tendered: 521 .25 Amount Paid: 521 .25 ' Change 0.00 SERVICE AD hans Due: DRESS / _ Thank You ( "L}/�.7� L 1 C f / fib`7S� User ID: RODRIGUEZM SUBDIVISION `I"` "`— LOT // /- BLOCK i P METER INSTAL BILLING ADDRESS �' ` �I \ }L"A == l CFC/WATER EMAIL ADDRESS: FPUA CFC ,.� ` \ "J `f, PHONE# MOVE IN/CLOSING DATE CFC/SEWER GUAR. REV. This application hereby requests and authorizes the Utility to render water and/or sewage disposal services to the premises described above in accordance with the Utilities present or future rates, rules and LATERAL regulations,which by reference are made a part of this contract.Applicant agrees to pay Utility promptly for such services in accordance with the established rules and regulations. $ TOTAL CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE. APPLICANT AGREES THAT APPLICANT WILL BEGIN PAYING BASE FACILITY CIIARGES FOR TBE UTHM SERVICE APPLIED FOR ON TBE DAY THE WATER METER OR OTBER UTILITY SERVICE CONNECTION IS INSTALLED AT APPLICANT'S PROPERTY,REGARDLESS OF WHEN APPLICANT STARTS UTILIZING THE METER AND/OR SERVICE. CUSTOMER SIGNATURE ' ( c SOCIAL SEC/FED ID (-, C1 7 'J > ! 70 NAME OF SPOUSE SPOUSE SOCIAL OFFICE USE ONIL DATE RECEIVED l��06 tt � G1 CASH CHECK# I i RECEIVED BY