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Home My WebLink AboutBUILDING PERMIT APPLICATION -Ali APPLICABLE 70- COMPLETED FOR APPLICATION TO BE ACCEPTED Date: I pGIVEI' Permit Number: �(} "' 0(1(� = County-t-i GO" St.Lucieitti 9 Buhr ing Permit Application 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 PERMIT APPLICATION FOR: Address: C��, F : tt� IA,A1 �1`�t7k'� ��: }—� 42r>i;1cr. Property Tax ID#: rj� � � 7}a (�J p Lot No. Site'Plan Name: Block No. Project Name: 5,M W, - WE --ems .. ' 1r WE- - t. miln, - •� � ;.. INE 0ViiRKA16 ZIZel0c2t2k-2D L New Electrical Meter L/ Second Electrical Meter (Affidavit required) NMM ggq c• _., � - �.=�=-^- z.'Y`�-:, s�- ;. 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 Construc ' n: Sq. Ft. of First Floor: Cost of Constructio : $ 23 0 O , 00 Utilities: Sewer _Septic Building Height: RE ME RAo bA 4Name 9`/�T`�Q ¢-1 c� _�•_� '(,-i��.� Name: -4i_c i �� 1, (. Address: 3V� s. _1 uJJ114�tJ iVa +2- Company:Ablk Lt�,s-Lz�IC. City: 1 T; E,2�� State: I=�- Address:'t�,D, ,JGc),. . ',6r, _c� Zip Code:34t 76 -7- Fax: City: State: Phone No. 13 & --qq 3 ` 3 q v 3 Zip Code:3q 7 S Fax: E-Mail:-Qq DN15�r a1^ t tV, CQQ' -Nk.Q,I L CO Imo- Phone No -7 7 Z. Z 9q 2-1 0 7— Fill in fee simple Title Holder on next page (if different E-Mail. OR F-LK F-1C C.MA I'- , C'�M _ from the Owner listed above) State or County License C_06DO 1 2- 1 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. J 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: ur failure'to Record a Notice of Commencement may result in paying twice for impgove�n ent to y �u prop rty. A Notice of Commencement must be recorded in the public records of St. LLt'cy�2ot+�ntyfn� po ed on e jobsite before the first inspection. If you intend to obtain financing, consult wltll I' er oan at me ore commencingwork or recordingour Notice of Commencement. ure of Owner/Lessee/Contractor as Agent for Owner STATE OF FLORIDA COUNTY OF Sworn to or affirm an ubscribed be r me - Physical Presence or Zonrine Notarization ( Y this�day of 20 Name of person making statement. Personally Known OR Produced dentif on Type of Identification Produce (Signature of Notary Public-St e of FloridaILZ Commission No A_ tpRYPUB (.SeaIIELLEN VAUGHN fate 6f Florida�Notary Public }� Commission # GG 270079 MY CommisssihonryE/lxrypr�ires fll lll� REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 5 21 ..� or- 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 ar 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 Isere. t If you sell or _lease a building you have built or tmproved within one year after construction is complete, hen 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 perform 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 o meet the minimum code. Initial here. I understand that as an owner-builder that any contract disputes with sub-contractors and I must be hiandletin 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. I,understand that if any person that is unlicensed and uninsured gets injured on my construction project-they maybe 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 permit application,and initial the above I hereby acknowledge that I have read and understand the above.discla� r stat ment Lknedgg d tht I further understand that any violation of the terms of the'owner/builder exemption shal� , rep edding and Zoning Department to the Florida State Department of Professional Regulaf o . e anded on thisday of�WcA�L of20� t 4- er/Builder Signature STATE OF FLORIDA COUNTY OF The foregoi g instrume wigs owledged before me this (3_.day o4 20�. by - who is personally kn' to me,or who has produced as etYPp ELLEN V r State Of,Florida NUGH N k� =� cdmmissio r Y Public Signa o No Type or Print Nam No '�°;,;; My Commissi� � 007� xpires Title:Notary Pu 'c' 'Commission Number —-�0tober : .:_ 9X$