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Home My WebLink AboutSUBMITTED PAPERSAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: %0 01n Permit Number: 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 Residential PERMIT APPLICATION FOR: I �/f/' err ek C_ t Address: Legal Description: Property Tax ID #: 0V D - ' io 6 1 AC2 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: Aaanionai worK to ne pertormea .unaer this permit— cnecK all tnat apply: _Mechanical _ Gas Tank _ Gas Piping _ Shutters. Electric _ Plumbing _ Sprinklers _ Generator Total Sq. Ft of Construction: Cost of Construction: $_ _. Sq. Ft. of First Floor: _ Utilities: —Sewer —Septic Windows/Doors Roof Building Height: T_ v ,S --s�,s, ... __�.e......_. �...._.a,�..r.T..�—...evs� 2.rr..�..,� sr_.:.�..�n...�v�t._.,:.w.tse".,..r3.� .�a::.s_� _..? _..,+ir•._csc ea .�� -•:-5. r '� r rA. �� ty�' a..s+:...c..._....�1_...}c� x,.....�. _��-.�.........�-��__�....3 �;..�� s_��.�w..+> ;. et._...:�.r .+..�` e.�� Name 4,. i % L. • •. " `•• it ♦� & City:•• • • • " Phone N712 o. , • Code: d Phone No. Fill in fee simple Title Holder on next page (if different E-Mail: from Owner listedabove) • County If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. rDESIGNER/ENGINEER:' _NotApplicable MORTGAGE COMPANY: _ Not'Applicable 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. 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 bylaws rules, 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. Signature of Owner/ Agent/ Les Signature of ntractor/License Holder STATE OF FLORIDA STATE OF FLO IDA COUNTY OF S V-. I—v c � t COUNTY OF The for oing instrument was acknowledged before -me The forgoing instrume t was acknowledged before me this day of Q c.' , 20.11 by this day of 20_ by Or^ k hy1 (Name of person acknowledging) (Name of person acknowledging (Signature of Notary blic-State of Florida) (Signature of Notary Public- State of orida ) Personally Known OR Produced Identification Known OR Produce dentification Type of Identification Produced l io ` BENS ttate of Identification Produced of Commission No. 6 ,, ()y Q°es pec 1.2mission ,F Jersonally No. (Seal) No1acY commis C016hi FRONT �-RWNVW ZF U dREVIEWS UPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW* REVIEW DATE - RECEIVED DATE COMPLETED Rev. 7/2014 l Planning & Development Services Department '� _ Building &Code Regulations Division -,ry--- - '- 2300 Virginia Ave - - - - Fort. Pierce, FL 34982 . 7 2-462-1553 t--.-�I��i�l�-al•�Coa><tractang...�._._....._ :..._ ........_,._......._:.:....-_� DISCLOSURE STATEII T . F.S. 489.503. -(n_EXEIVIPTIONS State law.requires electrical contracting to be done by licensed electrical contractors. You have applied fora. -- permit under an exemptionrtn thst la►�v �'lie:exemptiori-allor�vs your as owrier'ofyour.properiy -to act as your own electrical. contractor even though you do not have. a license, You may install electrical wiring- fora farm outbuilding or --a single-family:or .driplex residence: You mays install. electricalywiri�g.in anal-biiilctiMrt,P.., . ��JLL0LL 11Vl1Vli UNL5 u1 wnrcn are under-V5,000_ The home or, building nusf be£o yout.:ovvu use=anduocc �-It. _- —rnay not be built for sale: or lease. If you sell or lease more :than one buildin up�oy g.you have wired yourselfwithin:l.year after the construction is .complete, theaaw will presume thatyou.built it for°sale orlease, which" '.a violation ofthis -exemption.. You n*ymot hire. an unlicensed person as.your electrical contractor:_ Youi construction shall:be:done acbording:to building codes:and zoning.regulations. It is -your responsibiliiy to make sure that.people employed by. you have licenses required by state 'law county or muriicipal licensing ordinances. Failure to do so may result =.. in .a .liability for you! . - . ..... .. To qualify for this exemption under.this subsection, an owner.must.personally appear and.sign the building permit- application: I.hereby acknowledge that 1-have read and understand the above disclosure:.statement and that I _further.understand.that.any.. violation-ofthe terms.of the owner/bu der exemption-shall-be:reported'by•the� - +CommunrtyDevelopr ientDirector•.to.the-tlorida State .DepartmentofProfessionalRegalafion. Signed and acknowledged on this day of 20 OWNERABUILDE IGNATURE .STATE OF FLORIDA COUNTY OF C The foregoing instrument was acknowledged before me this * .A day of C 20 • , who is personally. known to me or DEPNNP stake of F�ocida has produced '�L L. cation. pub"C "ec �6 2p18 /. `;�PKY'PUB�c,. Notacy ExPtces�Ea5g�61 ti. CT• \ �/ `• • : My �0� fission # E °lacy Pssn. Signature ofNota-Print.-name=• •�c°u9hNat'0nai� of Notary OF Title: Notary Public Commission Numher :SLCPDSD Revised 7/23/2DIO St. Lucie County Owner Builder Affidavit -Electrical Contracting Planning & Development Services Department Building & Code Regulations 2300 Virginia Avenue Fort Pierce, Florida 34982 (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�pplicable laws, ordinances, building codes, and zoning regulations. Initial L1 I understand that the building official and inspectors are not there to design or give advice on ho to meet 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 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 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 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 Zoning Department to the Florida State Department of Professional Regulation. Signed and acknowledged on this day of of 20 1 _ Owner/Builder Signature STATE OF FLORIDA COUNTY OF Sk _ i— V C.\k. 1 The foregoing instrument was acknowledged before me this �i day of d G Y , 20_M, by (_\-%e. c S Q I �^'^ who is personally known to me, or who has � produced as identification. NP04�eg,F\o��do 6 \y 0 21 V-0- Y6 O�PN`c•s�aQe°�6�61 Signature of No Type or Print Name of Notary `any Qoe �� s5ga�y psso Title: Notary Public Commission Number `' '� *°y tom m;55�ooNa`\ooa�No� Zh �0ogr SLCPDSD Revised 05/15/2014