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Home My WebLink AboutBuilding Permit Package All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED O r n Date: k C) • �- -A Permit Number: RECEIVED o n OCT 2 12020 Building Permit Application St Li rouriyPlannin and Development Services Perryii Building 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: PdaMP _ `Nl' Address: Property Tax ID#: �oc)0w Lot No. G Site Plan Name: Block No. Project Name: - DE l ^ �i S Qm M{'�/�.P T�r�c J i 5 CCI uc�n;2�c� 1c , L;4TS 1 %s I'L Gh� �, bV C, New Electrical Meter Second Electrical Meter (Affidavit required) pQNSTR[ �T=N,,, AT(aN. u 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: $�a(20 •0() Utilities: —Sewer —Septic Building Height: �� C4NTRA� eOR.. Name _ Name: Address: '3 w,'i (�SQ!l'bL Company: City: /) ;Q ( State: L Address: Zip Code: Fax: City: State: Phone No. _7 " '7_ E- Zip Code: Fax: Mail: k t I 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. 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 attorney before commencing work or recording our Notice of Commencement. Q,,2, Signature of Owner/Lessee/Contractor as t nt for Owner STATE OF FLORIDA COUNTY OF Swor to or affi d nd subscribed b Y e me of Physical Presence or Online Notarization this day of 2 by Name of person making statement. Personally Known OR Produced Identification Type of Identi i tion Prod d (Signature of Notary Public-State of Florida) Commission No. (Seal) ;tPAYPU�o, KAREN S. NIELSEN ��;State of Florida-Notary Public =* *_ Commission # GG 207484 wFOFF`oe My Commission Expires June 12, 2022 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 5/20/21 Q1LUA, Planning&Development Services Department m Building&Code Regulations 2300 Virginia Avenue Fort Pierce;Florida 34982 RECEIVED (772)462-1553 OWNER/BUILDER AFFIDAVIT DISCLOSURE STATEMENT OCT 2 12020 F.S.489.103(7)EXEMPTIONS St.Lucie County Permitting 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 6 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 c es, and zoning regulations. Initial Her - I understand that the building official and inspectors are not there to design or give advice on how to meet the 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 cost of the license. Initial Here. pak� 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, ich 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 i 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 an acknowledged o this day of C1C of 20�. Ow er/Builder Signature STATE OF FLO A COUNTY OF T1 regoing i strument was a knowledged before me this c A day of ,20 b A.01 who is personally known to me,or who has produced as identificatio . T y.. KAREN S. NIELSEN ;2° ° ;State of Florida-Notary Public Signature of Notary Type or Print Name of Notary �ka fission #GG 207484 ' Title:Notary Public Commission NumberoF,°;c' My Commission Expires slit June 12, 2022 Gck 6� RECEIVED 0 C T 212020 St Lucie County. �b perm wNg. or ZVI y 9.�