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Home My WebLink AboutBuilding Permit Package All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I Date: � ' Permit Number: Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Residential Phone: (772)462-1553 Fax: (772)462-1578 Commercial PERMIT TYPE: Address: 5117- Lot No. Property Tax ID#: �`-(�� lJ?� 2 � �"f� dl� � Block No. Site Plan Name: Project Name: •. "7 '_s _? .`y;.= s w..,i n >'`4. �5". -` ,�z4'.: - i..F �" unSea-'T'y irF}'e g- � '� €�".. may'i -& ;g, y -.�'•.`s".i c' ^s r€t*�Jk-t,- f -SC R '^- .` -fg ,s�..s� OWN f R3 ,- .s `�'� - ems t ..x ,rya & xa e dX s� t€ 3 lb .--ra .e-ir1¢fr � �C� a. �:J;s .% -.r3s ..=.C3 ,E' er .:'s .��i y.;_., .rit � r...,].. e ;•`rF �'^ •_._ -:r -. Additional work to be performed under this permit-check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors Electric _Plumbing _Sprinklers _Generator —Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ � D'�— Utilities: —Sewer _Septic Building Height: AR �'-� 3 •. s " µ. s�€-�K.� s_sy� ,r. e z as , .. a y'26 :� �n„s -. e, •-'�. �T'� '�, '- ; Nu Name i!/��7 ,anv Name: Address:-2A.- �i �� fl(z�tJ� Company: City:O- �. _Zed �� State:_ Address: State: Zip Code: G Fax: City: Phone No. 7�L 6 dy 7 tvo��/ Zip Code: Fax: E-Mail: S` 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 construe-tiowis$2500 or more,a RECORDED Notice of Commencement is required. If value of HVAC is$7,500 more,a RECORDED Notice of Commencement is required. I �. EW - ^P 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 structure.Please colict nsult th w thpyoiurHle Home Owners ome Owners Association son and review your deed or any bylaws or an restrictions nts that which may a restrict or l .prohibit such 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 THE JOB SITE BEFORE THE F!RST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOU DER OR A ORNEY BEFORE RECORDi mG YOUR NOTICE OF COMMENCEMENT." Sign ure of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF 1�q(�.1�. COUNTY OF The for o 4qW ing instrument was acknowledged before me The forgoing instrument was acknowledoged before me this day of� by this day ofC, ev\ Ler Name of perking statement. Name of person making statement. tification Personally Known OR Produced Identification Personally Known OR Produced Iden Type of Identification Type of Identification Produced Produced (Signature of Notary, ublic- tate of Florida) (Signature of Notary Public-State of Florida ) Commission No. KA 'N NIELSEN Commission No. (Seal) `O�PaYP�ei State of Florida-Notary Public _, ._ mission # GG 207484 My Comm ssion Expires REVIEWS FR rt'�"`� \` -June 1 PLANS VEGETATION SEA TURTLE MANGROVE COU EVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. O Planning&Development Services Department • n = Building&Code Regulations 2300 Virginia Avenue Fort Pierce,Florida 34982 (772)462-1553 OWNERIBUILDER 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 di ; it is your responsibility to make sure that people employed by you have licenses required by state la n b c an or municipal licensing ordinances. nitial If you sell or lease a building you have built or improved within one year after con ction 's plet a presumption is created that it was built or improved for sale or lease,which is a violation of this xemptio . niti e. You may not delegate the responsibility for supervising work to a licensed contractor who is not license t p o the work being done. Your construction must comply with all applicable laws, ordinances, bu' tng c es, and zoning regulations. I ' ial H ar I understand that the building official and inspectors are not there to design or give advice o 0 o et e minimum code. I understand that as an owner-builder that any contract disputes with sub-contractors and I must be t court with the advice of an attorney. This department will not mitigate any contract disputes. In' I understand that if I compensate any person or company for work performed they are required to b d ' is jurisdiction. If for some reason they do not possess a license, I may be responsible and liable f e c of e license. I tial He I understand that if any person that is unlicensed and uninsured gets injured on my construction pr 'e be entitled to workmen's compensation. I could be held liable for all doctor, lawyer and related ica o hich could include loss of wages during recovery from their injury. It' To qualify for this exemption under this subsection, an owner must personally appear, si the uil ing 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 repo d by the uildi g and Zoni g Department to the Florida State Department of Professional Regulation. d ack e ed on this day of of 20& Owner/Builder Signature STATE OF FLO A COUNTY OF The fo pgoing ins in t wai cknov led befo a me this day of ,20 by 10 who is personally known to me,or who has rodI d as identification. tASL " KARE S NIELSEN Signature of Notary Type or Print Name of Notary ,o`�Y°"a,% g ry YP rY ;State of 9Q-NotaryPublic Title:Notary Public Commission Number =* Commission #GG 207484 ;r'01Fo My Commission Expires June 12, 2022 _..Ff f 'Y ST LUCIE UTILITIES DEP COMM ST LUCIE COUNTY UTILITIES P O:BOX 728 FT PIERCE FL 34982 2300 VIRGINA AVE _ a I C"RES a FOR T PI ERCE,FL 98 NAME .: 05 I /14j2021 13:34:5D M/F �777 7- REDIT CARD - IRR. _ - r SA ei VI SALE 'ECURITY-DEP Card;3 X�3{SOCQ()OCO�X 332 - 1 y� , -- — -7-E FEE'.'-" Chip ard: VISA DEBIT --� AID, A0000000031010 AMEYDAYTEE 5EQ 15 SUBDIVISION _ LOT BLOCK VERTIME FEE Batch 1640 = f Y INVOICE 16 TE_RINSTALL BILLINGADDRESS ,f1� lC Llt Ipproval Code: 498765 CFCf%WER Entry Method: Chip Read ` j� Mode: Issue- , FPUA CFC = pHONE#/ �� MOVE IN/CLOSING DATE Tax Amount: $0.00 CFUSEWER tTlus application hereby request and authorizes the Utility to render water and/or sewage disposal_, GR REV rvcstohmdscnbedaoue with the Uthhes pesent; b nJALE AMOUNT $521.25UA orfuture rates, LATERAL Hiles and regulations,which by reference are made.apart ofthis contract Applicant agrees to°pay tte Utility promptly for such services m,accordance with ahe established rules and regulaho_ns 7 TOTALS CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABI E CUSTOMER COPY soelAl,sEci =NAME OF-:SPO-[7SE SPOUSE SOCIAL$EC ,DATE RECEIVED "1 CASH CHK;# RECEIVED BY