Loading...
HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: `1 I a3I 15 Permit Number: 156 RECEIVED APR`•23 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 li PERMIT APPLICATION FOR: PROPC7SED INPR©1JEMENT LaCAT10�N: Address:__ _ 0? _.w .S'f, L(JCIE BLVD. EL PIERCE' FL �SWZ G Legal Description: Property Tax ID#: Iy2g`7QZ'12y7-OOU�L- Lot No. I Site Plan Name: Block No. S� Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DEaSCR�IPTI®N ®F V1lORK: 1 N 91 OMICA L CONNJ-Ma N (I 1 C II) FRO6_ UMER W Tri NP-W IAN KISS W]53 EATER Add CONS1'R'lJ'CTION hN'FO'RMATI�®N: itiona wor to a pe orme under this permit—check a that apply: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Electric _Plumbing _Sprinklers _Generator _Roof Total Sq. Ft of Construction: Sq. Ft. f First Floor: --Cost of Construction. �2�0_ �%' Utilities: ,Sr3wer':; ' Septic Building Height: © NE�R/ 5 i RON% iii LE:SSE�E: 1'1CONTR/ C'T®�R Name VAN.IEL .1 C121136!S Name: Address: oZVp Sr LVell &LVD. Company: - City: ET P1E4Q FAA. State:A& Address: Zip Code: Fax: kkw 17A,H61-771,4. City: State: Phone No. rf71� Zip Code: Fax: E-Mail: A Phone No Fill in fee simp Title Holde on next page (if different E-Mail from the Owner listed above) State or County License If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SU�PPLEIVIEN, NSl'Ft#UCTI®NN IEN LAU1/ CNF®RM/�1'ION: 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 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 conLmencing work or recording our Notice of Commencement. ignature of w er/Agent/Lessee/Contractor Signature,of Contractor/License Holder. STATE OF FLORIDA STATE OF FLORIDA COUNTY OF S-V- Ly c e COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this day of 0. t`i 1 20 15 by this day of 20_ by 4 '�-'-A C 105 (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary Public-State of Florida ) (Signature of Notary Public-State of Florida ) O N Personally Known OR ProduitcPersonally Known OR Produced Identification Type of Identifcation. ��ANCI,•�as ��`' a�vPS Type of Identification Produced �1,-0 L r1Q���S��o°a��'0� PrSduced _ ,,,.op, Commission No. �� _` :�.y G4g� or' Commission No. (Seal) . Z VG REVIEWS FRONT ONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 7/2014 RECEIVED APR 23 2015 Planning &Development Services Department +s 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 under 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 single-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 be built for sale or lease. If you sell or lease more than one building you have wired yourselfwithin 1 year after the construction 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 licenses required by state law and by county or municipal 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 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 Florida State Department of Professional Regulation. Signed and acknowledged on this .23 day of ,20�-TV . O R/B ER SIGNATURE STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this�_day of 4 ��1 ,20 by Q A v, e- C i-� b to S ,who is personally known to me or has produced t L �` as identification. 1 J a V\Y"d' 4%r%.5 (Seal) S Signature of Notany Print name of NotaryDtPNNP S��e°t g50ec\661 Title: Notary Public Commission Number v0% v L" �� °\any m s,S, psso Gom S�o� a�No\aN A M`! mm%s SLCPDSD Revised 7/23/2010 ••,sql F ., iii St.Lucie County Owner Builder Affidavit-Electrical Contracting