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Home My WebLink AboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED _ Date: Permit Number: 9 LLLIT E . �. 01 Building Permit Application Planning and Development Services / Building and Code Regulation Division Commercial Residentialy 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: Address: :2 600 Gr- P2 G R l k ftkC F'-` _(-i5 r • 3 q C? `d Property Tax ID #: •�� •-�B 2 Lot No. Site Plan Name: Block No. Project Name: RXI MA - _ New Electrical Meter Second Electrical Meter (Affidavit required) Om —iffis _0 i 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: $ �Oo • utilities: —Sewer —Septic Building Height: F IRK! P IN Name A: Ns0� S - ' Name: - Address: .z GDO •G RC tGA`� Y L: A.NE Company: City: f—,T p(:E:/ZC C =`' Sta"te: Address: Zip Code: Fax: City: State: q Phone No. �2 - �T-ai " �`SS �3 Zip Code: Fax: E-Mail: 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. MW �N DESIGNER/ENGINEER: G _ 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: 1!our 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 a posted on the jobsite before the first inspection,_ If you intend to obtain financing, consult with lend or an)attarney before commencing work or recording our Notice of Commencement. Signature of caner/ Le see/Con ctor as Agent for Owner STATE OF FLORIDA COUNTY OF za. Sworn to (or affirm and subscribed before me of —~ Physical Presence or Online Notarization this %DA day of Ut 2QDj by Name of person makin tatement. Personally Known OR Produced Identificati ny Type o Identification Produced Dkt-, As o ture f Notary Public- State of Florida ) LASHAHNAINGRW-RAHMING Commission No. (Seal) =+? MY COMMISSION #GG275060 :*_ F)(PIRES: December 20, 2022 . BondedThmNotary Public Undenrriters REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE. MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW 'DATE RECEIVED DATE COMPLETED Nev 5 2 21 ST l.uCeiF CO U N=T�Y F-L O R 1 D,A,,. 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 Iicensing ordinances. 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. Initial Here. - You may not delegate the responsibility for supervising work to a licensed contractor who is not licensed to pe rm the work being done. Your construction must comply with all applicable laws, ordinances, building codes, d zoning regulations. Initial Here. ay. I understand that the building official and inspectors are not there to design or give advice on how to meet the minimum code. _ I Initial Here. /Civil I understand that as an owner -builder that any contract disputes with sub -contractors and I must be handled in 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 th license. Initial Here. I understand that if any person that is unlicensed and uninsured gets injured on my construction project -they ma be 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 rmit 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 shal4rrepo by the Building and Zoning Dep nt to the Florida State Department of Professional Regulatiod acknow dged on thisday of of 2Qi .der Si ature STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this �J day of g, 20 , by, who is personally known to me, or who -has ro uced �,hn �;, "aatureofNotary C` , as identification. Cox" Type or Print Nam f Notary (Seal) Title: Not It LASHAHNAINGRAM-RAINING ion Number *; W COMMISSION # GG 275060 EXPIRES. December20, 2022 •''�'F �` g ••' Bonded Thtu Notary Pubtic Undorvrdters u 6 strut /a, C, ® C., m f -e"K t 6v fha�n �v'cc%Ac--&r A-0 5� a v t2 —pr 4r ST LUCIE DATE PLANS AN[ OR NO 'roe P-\ DIVISION W i BE KEPT ON JOB WILL BE MADE. \"A tA pep �ov fd C12 0 LA - j J;