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Home My WebLink AboutSUBMITTED PAPERSAll APPLICABLE INFO MUST BE COMPI D FOR APPLICATION TO BE ACCEPTED s ��/ Date: //-z � /y Permit Number. J I N — O &L SCANNED BY St. Lucie County Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 / Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residentialy PERMIT APPLICATION FOR: 4 II Address: 2/- Q Legal Description: Property Tax ID #: /1COCYC - j uE ti vE - /dreT S.-. G v c.E 1�-e-- Site Plan Name: I�FC-67 71 Y/S- SO/ - oo %/ - Uou /Z Project Name: Setbacks Front Back: Right Side: Left Side: Lot No. Block No. SD e�-1 c e o-v G//".�- ;mom art1o11d1 worK to ae perrormea unuer tms perms - cnec _Mechanical _Gas Tank _Gas Piping _ Electric _ Plumbing _ Sprinklers Total Sq. Ft of Construction: Cost of Construction- $ 30 Name /IFUNFTiY .�li�,vE,z _Shutters _Windows/Doors Generator _ Roof Sq. Ft. of First Floor: Utilities: _Sewer _Septic Building Height: Address /'V'Peao 'c /rcE 'V1rA1%F L. WiO 3 City: State: 1e Zip Code: Fax: Phone No. 7- j'GZ E-Mail:.*,/as �a� Plro fu+a�'/.row Fill in fee simple Title Holder on next page (if different from the Owner listed above) Na Address: 5- cA.vrE LZ vo ' City: Pc?' r L mac'� State: /--c Zip Code: Fax: Phone No vz "8SU3 E-Mail State or If value of construction is 2500 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 TITLEHOLDER: _ 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: Your failure to Record a Notice of Commencement may result in your paying twice for improvements to your property. A Notice of Commencement must be recorded 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. Signatu fe of Owner/ Agent/ Lessee/Contractor Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF r'aRJ COUNTY OF Thefor oing instrum n was acknowledged before me this rs � day of(� 20LJ! by The forgoing instrument was acknowledged before me this _ day of 20_ by (Nameof person acknowledging) IF (Name of person acknowledging) J (Signature of Notary Public -State ofT.Lorida) (Signature of Notary Public -State of Florida ) Personally Known OR Produced Identification sonally Known OR Produced Identification Type of Ident cati _ _ Produced •^^. L PAWN MILONE Notary Public -State of Florida Commission No. =• . �, tdt(5®{),. Expires Mar 22,2017 Commission # EE B77571 Type of Identification Produced ommission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. Planning & Development Services Department Building & Code Regulations 2300 Virgiuta Avenue Fort Pierce, Florida 34932 (772)462-1553 OWNERBUILDER 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. 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. 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. 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 ap�icpe laws, ordinances, building codes, and zoning regulations. Initial // Y I understand that the building official and inspectors are not there to design or give advice on he �t 9jeet the minimum code. Initial 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 K//-f 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 maybe responsible and liablgfo�e cost of the license. Initial .•�� '' 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 relate? e ical cost, which could include loss of wages during recovery from their injury. Initial /`r To qualify for this exemption under this subsection, an owner must personally appear and 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 Zjng Departme t� rj to the F rida Sta e : epartment of Professional Regulation. Signed and acknowledged on this o j day of lbf20 wnerBuilder Signature STATE OF FI COUNTY OF The fofegoing by Stgnnafiire of Notary Title: Notary Public SLCPDSD Revised 05/152014 60s 1 before me this a&day of A&f� 120 who is personally known to me, or who has as identification. ,aYa.,,, , Type or Print Name of Notary i s°, \ DAWN MILONE NQb'agljublic -State of Florida Commission Number � § • : U,`) tAy Comm. Expires Mar 22, 2017 :�,�p Commission # EE 877571 "'%R°„��`• Bonded Through National Notary Assn. y