HomeMy WebLinkAboutBuilding Permit Application (2) All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: l 2�2/ Permit Number: 0
RECEIVED
OCT 14 2020
Building Permit Application St.Lucie County
Permitting
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 CBDG Funding
PERMIT APPLICATION FOR: J v cA- C nC
�PRO'POSED IMPROVEMENT LOCATION:
Address: 120( S ou. j /-(
Property Tax ID#: 3 S/&— .3/5 — COO 1 f G/ Lot No. :3
Site Plan Name: K' Block No.
Project Name: '
DETAILED DESCRIPTION OF WORK:
" e L :C,14 oc% VCrc,C,0 d1Q
Qze-
New Electrical Meter Second Electrical Meter (Affidavit required)
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: $1 5 -00,,c)C7 Utilities: —Sewer. _Septic Building Height:
CONTRACTOR:
Name l� r�'t"' , S N (w Name:
Address: ")01 -9c;�c rrV rr , ompany:
City: w2t/ 1,pl-wes State:Fes. Address:
Zip Code: rid?A-,a. Fax: -- City: State:
Phone No. c> o E- Zip Code: Fax:
Mail: - /L !!� Phone No
Fill in fee simple Title Holder on dxt 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
"SUPPLEMENTAL CONSTRUCTIONLIEN-LAW INFORMATION:
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 conflicts with any applicable Homeowners Association rules,bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Homeowners 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 attorpey before commencing work or recording our Notice of Commencement.
x�la ) , // ��_ Ze, 4��
Si atu a of Owner/ sse /Con,tractor as Agent for wner
STATE OF FLORID = (� ) e_COUNTY OF �y�` )," J Q, /
Sworn tp(or affirmed)and subscribed before me of ✓ Physical Presence or Online Notarization
this )`I day of C_J1 2Q by
Name of person making statement.
Personally Known OR—P-roduced Idegtificati n,
Type of Identification Produced e b-- I 1 c—
(Signature of Notary P lic-State of Florida)
sscrosw,:s ^rsltw
Lf „•,Commission No. (Seal) AUDREY B.HUMPHREY
•aYP°��%•:
MY COMMISSION#GG 300817
EXPIRES:March 6,2023
,,,, _Bonded Thru Notary Public UndeM•ilers IN
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev
WOE
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 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, en 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 p rform
.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 ImVeb1tJe
minimum code. Initial Here.
I understand that as an owner-builder that any contract disputes with sub-contractors and I must be handled inl
court with the advice of an attorney. This department will not mitigate any contract disputes.
Initial Here. ,f 2;
I understand that if I compensate any person or company for work performed they are required to be licensed i 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 m 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 building pe it
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 acknowledged on this
day of of 2 /)
tz
wner/Builder tore
STATE OF FLORIDA
COUNTY OF ///
The foregoing instrumen as acknowledged before me this day of C ,20g) ,
by 1-C A who is personally known to me,or who has
produced as identification.
Sig1fature of Not e or Print Name of N ry =B.LndedXThru
..._
Title:Notary Pub is Commission Number UDREYB.HUMPFIrOMMISSION��XPIRES:M?r.ThruNat;
i
Planning and Development
Services Department
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Building & Code Regulation Division
Inspedtions
Helpful Hints for Owner Builders
Scheduling Inspections
• Inspections are typically performed the day after the inspection is scheduled.
• There are two ways to schedule an inspection:
a. Call 772-462-2172 or 462-2165 between 8 a.m. and 5 p.m., or
b. Go to St. Lucie County's Website, click on permits, click on online building
inspection system.
1. Enter permit number
2. Enter confirmation number (this number is on the top of your building
permit next to the building permit number.)
3. Enter
4. Click on the request next to the inspection you want to schedule.
5. You can schedule an inspection online until 9 pm Monday—Friday for next
day inspection service. On Friday, the inspection will be scheduled for
Monday. On Saturday and Sunday, the inspection will be scheduled on
Tuesday.
Day of Inspection
• Go to St. Lucie County's Website, click on permits, click on daily inspection
schedule.
• Locate your address or permit number, the screen will show-the inspector name
and whether the inspection is in the morning or afternoon.
• Inspections are listed in order of scheduled site visit.
Inspectors are available by phone at the numbers listed below from 7a.m. until
4p.m.
Andy Wentz 772-249-9502
Greg Smyth 772-370-0482
Walter Pride 772-370-2539
Dave Johnson 772-370-2548
Wanda Gahn 772-204-4237
Mary Chissoe 772-370-2543
Stephen Poreba 772-475-1063
Clyde Heffelfinger 772-200-6386
Doug Harvey 772-370-2542