The URL can be used to link to this page

Home My WebLink AboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED % O r� Date: �' Z z Permit Number: `� RECEIVED L? , R �'afkl4CLk�wa FEB 01 2022 '' Building Permit Application s,.LucieCounty Permitfmq 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: PROPOSED IMPROVEMENT LOCATION: — Address: 5...�d �( ILc�� ►�1�J� T�C�� r� f%�c t��- Property Tax ID #: Lot No. Site Plan Name: Block No. Project Name: DETAILED DESCRIPTION OF WORK:-- �5+��1 rv4 s�/-J e+-=I- -f--v New Electrical Meter Second Electrical Meter _ (Affidavit required) CONSTRUCTION INFORMATION: A�r - 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: $ J (/ Utilities: —Sewer _ Septic Building Height: OWNERAESSEE: J CONTRACTOR: Name 1< i G%o�-r� cJ�T�` Name: Address:. c'n+vT_--e 7�_cl Company: City: El r ✓'L_zf1 State: �L Address: City: State: Zip Code: 7 L( CI �_Z Fax: Phone No. 6-6 % Z cj 6 '1 /u E Zip Code: Fax: Mail: (T r C � V-0 T �'y s=j %U- P 6 ,Phone No Fill in fee simple Title Holder next page (if different E-Mail I ! State or County License - from the Owner listed above) 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. PLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: f FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable I 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 your Notice of Commencement. I Signature of Contractor - or - Owner Builder as applicable STATE OF FLORIDA COUNTY OF,r�,. Sworn to (or affirmed and subscribed before me of Physical Presence or Online Notarization this J day of 20 zzbSr Name of person making statement. Personally Known OR Produ d Identification Type of Identification Produced (Signature of Notary Pub]/State of Florida) Commission No. (Seal) HEATHER BURFORD 'AYP( / Public 2- State of Florida- otarY #GG 183217My =Commission Commission Expires February �5, 2022 Wtnie"__ FVIEWS FRONT ZONING SUPERVISOR PLANS I VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW I REVIEW REVIEW REVIEW , DATE RECEIVED j DATE COMPLETED Rev --- — 97O LUC HR O Planning & Development Services Department s . 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, then a presumption is created that it was built or improved for sale or lease, which is a violation of this exemption. Initial Here. 41 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 to meet the minimum code. Initial Here. n� 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. A k-'-- 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, which could include loss of wages during recovery from their injury. Initial Here. ZdN/ 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 owner/builder exemption shall be reported by the Building and Zoning DepartmSW Jo the Florida State Department of Professional Regulation. Signed and acknowledged on this day of of 202,_Z Owner/Builder Signature STATE OF FLORIDA COUNTY OF fj47 LJCry_ The foregoing instrument was acknowledged before me this / day of /� 20 ZA by who is personally known to me, or who has produced 7U> 1_ as identifica o p�� HEATHER B�IRFORD State of Flo�icia-Notary Public e or Print Name of Not - Commission a GG 18 Siafore of Notary ry Type �: MY Comm�s� Expires Title: Notary Public Commission Number February n5, 2022 ST LUCIE UTILITIES DEP 2300 VIRGINA AVE FORT PIERCE, FL 34982 C12/4 2022 CREDIT CARD VISA SALE Card # Chip Card: 71D: SEQ #: G&h 4: INVOICE Approval Code: Erity Method: Mode: SALE AMOUNT i COMM RES 14:39:53 M/F XXXXXXXXXXXX3546 CAPITAL ONE VISA A000000O031010 18 1817 22 08615D Cho Read Issuer CUSTOMER COPY $521,25 IRR ECURITY DEP IERVICE FEE TAME DAY FEE )VERTIME FEE VMTER INSTALL. "FC/WATER FPUA CFC 1 CFC/SEWER GUAR. REV. LATERAL TOTAL ST LUCIE COUNTYUTILITIES- P.O. BOX 728, FT. PIERCE, FL 34982 NAME 1 C. �` t OL i /` () f C. AccT. # � SERVICE ADDRESS T iJ SUBDIVISION ttl LOT 40 BLOCK BILLING ADDRESS r lJ v J c_,. �� ,i ✓�"'r� . " 1� c` tee—, I~ � � ` � 1 / PHONE # 7� ~V/ c� (� it g/JMOVE IN/CLOSING DATE �i'�LG-r • 'This application hereby request and authorizes the Utility to render water and/or sewage disposal services to the premises described above in accordance with the Utilities present or future rates, rules and regulations, which by reference are made a part of this contract. Applicant agrees to pay the Utility promptly for such services in accordance with the established rules and regulations. CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE. SOCIAL SE G f j' 6 FED ID � LJ NAME OF SPOUSE n 4" �I T fa" SPOUSE SOCIAL SEC. OFFICE USE ONLY ^^�� ^y d DATE RECEIVED Chi 1 ' +� CASH CHK # IVED BY �' ` l