Loading...
HomeMy WebLinkAboutRevisions OFFICE USE ONLY: ��11 t- It'E PERMIT# DATE FILED: Olt t GI/� t na REVISION FEE: RECEIPT# PLANNING & DEVELOPMENT SERVICES RECEIVED BUILDING&CODE REGULATION DIVISION MAR 01 2022 2300 VIRGINIA AVENUE FORT PIERCE, FL 34982-5652 Permitting Department (772)462-1553 St, Lucie Countv APPLICATION FOR BUILDING PERMIT REVISIONS PROJECT INFORMATION LOCATION/SITE ADDRESS: 0�j Ov o�Z�U� p�v� , �►�1 P����� , PL-- '3U't((A DETAILED DESCRIPTION OF PROJECT / REVISIONS: DW6k r �E T P! CONTRACTOR INFORMATION: STATE of FL REG./CERT. #: ST. LUCIE CO CERT. #: BUSINESS NAME: QUALIFIERS NAME: ADDRESS: CITY: STATE: ZIP: PHONE(DAYTIME): FAX: OWNER/BUILDER INFORMATION: 0 NAME: Key �tiC� � E . ADDRESS: CITY: 6 �� P i ccZLE STATE: _ PHONE (DAYTIME: FAX: ARCHITECT/ENGINEER INFORMATION: NAME: ADDRESS: CITY: STATE: ZIP: PHONE (DAYTIME): FAX: SLCCC: 9123109 Revised 06130/17 NOISIA3H I r I i Abu" PRoPRcTy 6 Nc `c o' MIN. SETBACK RE flN FRONT SIDES CNR SIDES N REAR Ib' ZNG. W TECH. - - - - - - ' i tj4h FILE a a��� o��e3y Luc )r4 4 wM J T w OFFICE USE ONLY: fifi r// PERMIT# DATE FILED: REVISION FEE: RECEIPT# PLANNING & DE VELOPMENT SERVICES RECEIVED BUILDING&CODE REGULATION DMSION MAR 0 12022 2300 VIRGINIA AVENUE FORT PIERCE,FL 34982.5652 Permitting Department (772)462-1553 St. Lucia County APPLICATION FOR BUILDING PERMIT REVISIONS PROJECT INFORMATION LOCATION/SITE ADDRESS: O�'�rkEJ� PcU rO i l C� ce DETAILED DESCRIPTION OF PROJECT j REVISIONS: ,-- - *7 CONTRACTOR INFORMATION: `�✓� L��AU lJ' STATE of FL REG./CERT. #: ST. LUCIE CO CERT. #: BUSINESS NAME: QUALIFIERS NAME: "� — ADDRESS: CITY: STATE: ZIP: PHONE(DAYTIME): FAX: OWNER/BUILDER INFORMATION: O NAME: y \I\- k V3 EN)61 ADDRESS: O E CITY: � i cct LE STATE: _ ZIP: 31 I PHONE(DAYTIME: FAX: ARCIIITECT/ENGINEER INFORMATION: NAME: ADDRESS: CITY: STATE: ZIP PHONE(DAYTIME): FAX SLCCC: 9123109 Revised 06130117 _ - y s lily � I l 9 55 AM Google Maps 11IN iiol 68Y • . 68 Imagery 02022 Maxar Technologies,U.S.Geological Survey,Map data©2022 100 ft https:/twww.google.com/maps/@27.4480266,-80.4210994,137m/data=!3m1!1 e3 1 r 1 All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number:Yk 070, L - '� Building Permit Application 29 24 NOV Planning and Development Services LE . untY Building and Code Regulation Division Commercial Residential St'E?Arrrot_n9 2300 Virginia Avenue, Fort Pierce FL 34982 Phone:(772)462-1553 Fax: (772) 462-1578 71 PERMIT APPLICATION � —�- O (pt__V Address: 15 No. Property Tax ID#: Block No. Site Plan Name: Project Name: M____ w Electrical Meter ecia tletrical Mete {�►`✓� New oi c r � �c6 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 Construct aCz� Utilities: —Sewer _Septic Building Height: Name l Name: Address: OK I Company: City: FL>2: Pii�_711L'F_ State:Il I Address: city: State: Zip Code:�l�— Fax: Phone No. Zip Code: Fax: E-Mail: ;Ai MC;4. L V Ake—a(II-S Phone No Fill in fee simple Title Holder on next page ( if different E-Mail from the Owner listed above) i State or Cou License Iif 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 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 bf 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 improv nts to your property. A Notice of Commencement must be recorded in the public records of St. Lucie C un y and posted on the jobsite before the first inspection. If you intend to obtain financing, consult with Linde or an attorney before commencing work or recording our Notice of Commencement. k nature of Owner/ ess a/Contracto as Agent for Owner STATE OF FLORIDA COUNTY OF Swonts,(or affirmed) and su cribed before me of P al Presence or Online Notarization this /day of /�� V , 20_ �y ps) II, Name of person making statement. Personally Known OR Produced Identification Type of Identification Produced ► _ (Signature of Notary Pu f Ior4aL)LEN VAU 11=41�11 �= fate of FloridaA(JdHN Commission No. oP k0blic A . #GG 2�00 9_ m fission Expires 9 REVIEWS FRONT • ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 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 teasing 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. _� .5 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. S .� 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 mea 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. S 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 th license. Initial Here. 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 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 re orted by the Building and Z Dep ent to the Florida State Department of Professional Regulation igne acknowledged on this TO day of of 20).1 . wnerBuilder Signature STATE OF FLORIDA COUNTY OF S#AtaT LA.ACZr 9g The foregoing instrument was acknowledged before me this & day of 20ti'` by who is personally known to me,or who has produced as identification. Signature of Notary Type or Pnnt Name of Notary • Title:Notary Public Commission Number HEATHER BURFORD �.•ICY pig I� r% ',Notary Public-State of Florida `= Commission#HH 218910 My Commission Expires 'obruary 06,2026