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HomeMy WebLinkAboutBuilding Permit 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 YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING CONSULT WITH_XQUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." otureof i Signe20essV ntractor as Agent for Owner Signature of Contractor/License Hold STATE OF FLORIDA STATE OF FLORIDA COUNTY OF 5�. t.0 c �< COUNTY OF The forgoing instrument was acknowledge before me 4l The forgoing instrument s acknowledged before me this _day of A C .1 20a by this _day of , 20, by �' 1r1 Y+�rB-�v Name of person making statement. Name of person king statement. Personally Known OR Produced Identification Personally Kn n , .OR Produced Identification Type of Identification Type of [den ication I Produced ��O L Produced (Signature of Notary 1' µNAGNENJ4", (Sign ture of Notary Public- State of Florida.r.,�y0�Commission No.�i Sreg► No. (Seal) ,rCommission Cc�pires Jational µ Bnoded throu8 REVIEWS FRON ZONING SUPERVISOR PLANS I VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW I REVIEW REVIEW REVIEW DATE RECEIVED DATE 'Rev. COMPLETED 217119 91r. WCUIEZA O Planning & Development Services Department Li'mmmovel-W95 Building & Code Regulations 2300 Virginia Avenue Fort Pierce, Florida 34982 RECEIVED (772)462-1553 OWNER/BUILDER AFFIDAVIT DISCLOSURE STATEMENT APR 15 2021 F.S. 489.103 (7) EXEMPTIONS rarmitticg Department St. Lucie -cur1ty 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. R H 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. n Initial Here. R 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 cod and zoning regulations. Initial Here- � t" I understand that the building official and inspectors are not there to design or give advice on how to e he minimum code. Initial Here_ 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 coo the license. Initial Her 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 whi h 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 ownerlbuilder exemption shall be reported by the Building and Zoning Department to the Florida State Department of Professional Regulation. Signed a d acknowledged on this day of of 20 O uilder S ature STATE OF FLORIDA COUNTY OF 4_�r . LV The foregoing instrument was acknowledged before me this V5 day of °� � \ , 20�, by 0. d�w•na►p 1►V���`%�M who is personally known to me, or who has produced F L ��-- as identification. "``` DEANNA GIVENS :`X. Notary Public • State 0f loriL' Comm}}�ion x HH 086354 Signature of Nota Type or Print Name of Not F,d ' My Comrt+ �jt#k�s Jan 29- 2025 OF Title: Notary Public Commission Number d Bonded through Nationa Notary Assr.