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Home My WebLink AboutSUBMITTED PAPERSALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: '� - i O' �S SCANNED Permit Number:BY St. Sf. Lucie County • .. __.._ RECEIVED Building Permit Application Planning and Development Services APR 10 2015 Building and Code Regulation Division 2300 Virgini� Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential F PERMIT A�P,LICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION: Address: Legal Description: Property Tax ID #: 2 f & on 7 Lot No._ T TT Site Plan Name:, Block No. Project Name: Setbacks Front Back: Right Side: Left Side: Additional work to be nertormed under this permit — check all apply: E1HVAC LI Gas Tank Gas Piping _ Shutters a Windows/Doors Electric ❑ Plumbing Sprinklers .� Generator Roof Total Sq. Ft of Construction: S : Ft: of First Floor: Cost of Construction: $ A Utilities: Sewer 0Sept ic Building Height: r OWNER/LE�SSE��: CONl"RACTOR: Name* Address: 4� City: G Zip Code: &�,022 Phone No. E-Mail: Fill in fee simple from the Ow i � Name: — Company: — — State: L QC r7 Fax: ANCity: 7 !7 1 15: Address: State: Zip Code: Fax: Phone No. Title Holder on next page ( if different er listed above) E-Mail: State or County License: If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUP'PLEMENTA� CONSl'R+U ON LIEN LAUV INiOR+MA►TION DESIGNER/ENGINEER: _ Not Applicable Name: MORTGAGE COMPANY: _ Not Applicable Name: Address:... Address: City: State: Zip: Phone: City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: BONDING COMPANY: _Not Applicable Name: Address: City: Address: City: Zip: Phone: Zip: Phone: 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 commeKinR worWlor Wcording your Notice of Commencement. _ v �/ s _ Sig a r-e_: f=" =-� iy '/ essee/Agen N e Signature of Contractor/License Holder STATE OF FLORID iy �Q = STATE OF FLORIDA COUNTY OF COUNTY OF The forgoing instru t was acknowledged re r, - this O day of 20 �by o oa A d UX $ ou Name of person acknowledging ) ( ignature of tary Public- State of Florida ) Personally Known OR Prb "Identilication Type of Identification Produced Commission No. (Seal) Revised 07/15/2014 The forgoing instrument was acknowledged before me this day of , 20 by (Name of person acknowledging ) (Signature of Notary Public- State of Florida ) Personally. Known OR Produced Identification Type of Identification Produced Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS Planning & Development Services Department Building & Code Regulations Division 2300 Virginia Ave Fort Pierce, FL 34982 772-462-1553 Owner Builder Affidavit — Electrical Contracting DISCLOSURE STATEMENT F.S. 489.503 (6) EXEMPTIONS State law requires electrical contracting to be done by licensed electrical contractors. You have applied for a permit ur der an exemption to that law. The exemption allows you, as the owner of your property, to act as your own electrical contractor even though you do not have a license. You may install electrical wiring for a farm outbuilding or a sing e-family or duplex residence. You may install electrical wiring in a commercial building the aggregate construction costs of which are under $75,000. The home or building must be for your own use and occupancy. It may not a built for sale or lease. If you sell or lease more than one building you have wired yourself within 1 year after the onstruction is complete, the law will presume that you built it for sale or lease, which is a violation ofthis exemption. You may not hire an unlicensed person as your electrical contractor. Your construction shall be done according to building codes and zoning regulations. It is your responsibility to make sure that people employed by you have icenses required by state law and by county or municipal licensing ordinances. Failure to do so may result in a liabil ty for you! Tb qualify for this exemption under this subsection, an owner must personally appear and sign the building 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 Community Development Director to the FlorA State Department of Professional Regulation. Signed and acknowl dged on this 10 day of , 20%_. ER SIGNATURE STATE O)j FLORIDA ��— COUNTY OF; The forego, ng,instrument was acknowledged before me this / 0 day of 20Iy�, N byi g who is personally known to me or has rodu ed as identification. = o2 m U5 ,[ii M W 2 Signature f N ary V Print name of otary a VU g � Title: Notf ry Public Commission Number ay?°'rd SLCPDSD Revised 7/23/2010 St. Lucie CointvlOwner Builder Affidavit -Electrical Contracting s w 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 ,emption to that law. The exemption allows you, as the owner of your property, to act as your own contractor even ough you do not have a license. You must provide direct, on -site supervision of the construction yourself. You ay build or improve farm outbuildings, a one -family or two-family residence for your use and occupancy. You ay also build or improve a commercial building at a cost not exceeding $75,000.00 as long as it is for your own ;e or occupancy. You may not build or improve said structures for the purposes of selling or leasing that building. you.sell or lease a building you have built or improved within one year after construction is complete, then a esumption is created that it was built or improved for sale or lease, which is a violation of this exemption. You ay ,not hire an unlicensed person to act as your contractor or to supervise people working on your building; it is iur responsibility to make sure that people employed by you have licenses required by state law and by county or anicipal licensing ordinances. You may not delegate the responsibility for supervising work to a licensed ntractor who is not licensed to perform the work being done. Your construction must comply with all applicable ;vs, ordinances, building codes, and zoning regulations. Initial I understand that the building official and inspectors are not there to design or give advice on how to meet minimum code. Initial I understand that as an owner -builder that any contract disputes with sub -contractors and I must be handled a civil court with the advice of an attorney. This department will not mitigate any contract disputes. Initial'/70 i unaerstana inat tt i compensate any person or company for work pertormed they .are required to be ,sed in this jurisdiction. If for some reason they do not possess a license, I may be responsible and liable for the of the license. Initial �7 I understand that if any person that is unlicensed and uninsured gets injured on my construction project - may be entitled to workmen's compensation. I could be held liable for all doctor, lawyer and related me4ical 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 It application and initial the above. I hereby acknowledge that I have read and understand the above disclosure statement and that I further tand that any violation of the terms of the owner/builder exemption shall be reported by the Building and Department to the Florida State Department of Professional Regulation.. Signed and acknowledge n this day of of 20 _tj� Owner/Builder Sijfria7fr STATE OF FLORIDA CO�JNTY OF , Th� fo egoing instrument was ac cnowledged before me this day o A'� 20L, by who is personally known to me, or who has prof uc d , as identification. �;0&1) or Si a re7oTmotwl Type or nt Name of Notary (Seal) Title: Notary 1 110' Commission Number SLC�DSD Revised 05/15/20I4 �m41PsPUo9 Ao�',,• '•.�' *- veW�'a Zn9 y°� p,SSIWWO� !.W ''%�na •c��s ZU-�b�d�N 913�