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Home My WebLink AboutSUBMITTED PAPERSAll APPLICABLE INFO MUST BE COMPLEX 'fOR APPLICATION TO BE ACCEPTED Date: SIT y, SCANNEDPermit Number: A 5j"t " d3ay 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 PERMIT APPLICATION FOR: Address: Legal Description: Residential Property Tax ID#: 3h �q " I OaoLI Lot No._ Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: _Mechanical _ Electric perrormea unc Gas Tank _ Plumbing Total Sq. Ft of Construction: Cost of Construction: $ is permit — Gas Piping Sprinklers all that apply: _ Shutters Generator Sq. Ft. of First Floor: _ _Windows/Doors Roof Utilities,, �Se�wer, - Septic Building Height: g��y,� `-;-*.e - q �:}sue z t''' �.. m.'r+e7"'r`y�'�,`m' a -^Tr �,'"� '�jj 4g=t ;,.R,a�h`/j(J�t 2«Y .,[.rcr ±�y c, z' .� �• � .�.,h't•�.._"ks}y..��`� } �. .-sE1s s ��^ t r �, � sue. # •'. H`T'r,'.� .� � �� r �. °�ii �5x1�.-4y.F�}t �.P }'s": ��u:::s...��'k• x � �ti�rrY;...�r�..;.'`'x'.�i.�s..�.".«..._S �`•g�.l.�-,.`i`S,>P rr ^_...t..1v°:�i', l - city: State: Zip .. - i, k3 Fax: Phone llo--:73T ..- i(// l I e0M Phone E-Mail: Fill in fee simple Titl-.:nnex"t�p'age (if different above)from the Owner listed If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. -z r--S� yys � a �vt �.°.fY"a"f -. _ ��,: tir-ra � FF r ,T t z ,--.•- a x.-..,.-�.; ��, ,�- A"Er �„ -- x Not Applicable UT@=C1WK@1 171 IVJ 0• '•• • 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 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 your Notice of Commencement. Signa re n / Agent/ Lessee Signature of tractor/License Holder STATE OF FLORIDA STATE OF FLORI COUNTY OF S k . V t � COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was nowledged before me this day of ' Q�q 20_j_� by this day of 20= by (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary Public- State of Florida) (Signature of Notary Public- State of Florida ) Personally Known O,ag cJuced Ideff5Flffii�WENIS `P 5tatt-otFww Personally Known OR Produced Identification Type of Identification Pr 'laawy, Public - 6 Type of Identification Produced •,_; g��` ssion #� EE 858761 Commission No. �� .9, p•• National Notary Assn. Ugh Commission No. (Seal) Bolt REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Kev. i/LU14 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 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 li le laws, 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 the minimum code. Initial 1/0 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 fort 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 related me i al 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 O r ig ture STATE OF FLORIDA COUNTY OF 'S k I %- J e R The foregoing instrument was ackn wledged before me this1ke, day of Q20� by Cq-C rn� �n -Ae,Z who is personally known to me, or who has produced L as identification. pEANNA GIVENS �l ° ly P`1 bl' - State of Florida Signature of Type or Print Name of Notar _ ° Notary g Y YP Y '_ • • .: My Co Mires Dec 16, 2016 Title: Notary Public Commission Number qS o•: Commission #r EE 858761 "' h National Notary OF F,QBonded Through y Assn. SLCPDSD Revised 05/15/2014 Planning 8:[)evelapm®nt Services Building & Godi egulation,Divis on. 2300 Virglnla;Avenue. Fort:P,lerce, FL U4 82 Phone:(772j462-2172 °Fa) (TT2)4624443 August 22, 2014 CARMEN HERNANDEZ 904 Osceola Dr Fort Pierce, FL 34982-7682 RE: Building Permit Number 1408-0324 ASBESTOS NOTICE TO OWNER/BUILDER FILE C®P Disclosure Statement: State law requires asbestos abatement 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 you own asbestos abatement contractor even though you do no have a license. You must supervise the construction yourself. You may move, remove, or dispose of asbestos containing materials on a residential building where you occupy the building and the building is not for sale or lease or the building is a farm outbuilding on your property. If you sell or lease such building within one year after the asbestos abatement is complete the law will presume that you intended to sell or lease the property at the time the work was done which is a violation of this exemption. You may not hire an unlicensed person as your contractor. Your work must be done according to all local state and federal laws and regulations which apply to asbestos abatement projects. It is your responsibility to notify the Department of Environmental Protection of your intention to remove asbestos. It is your responsibility to make sure that the people employed by you have licenses required by state law and by county or municipal licensing ordinances. O ignature & Date 8/22/2014 12:41:07 PM