Loading...
HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 2 Permit Number: RECEIVED Building Permit Application ..FEB 2 9 2096 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: t G, e PROP SED INPUIENT L�CAT!®N: Address: G�.3�� PAS 0121 Z Q_,5- Ay� Legal Description.* Property Tax ID#: K7 0 a ;j-b (3 D 0 Lot No. Site Plan Name: Block No. Project Name: ;_ a��n . S. Setbacks Front Back: Right Si Left Side: 1/ DETAILED DESS*R11PTlON _ Z. �a - CON5TR�l1CTIOpN,,INF®R+iUTATI® Jimx Additional work to be performed under this permit—check-.all that h appy: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Electric _Plumbing, I _Sprinklers _Generator _Roof Total Sq. Ft of Construction:& �(�/'/ Sq. Ft. of First Floor: Cost of Construction: $ Utilities: ;._Sewer _Septic Building Height: 0 ®UV SER/�,E�SSEE C®NRA�T®R: Name C Se (4 Name: Address: .VL Company: City: 4i"l State: Address: Zip Coder L4 91-1,6 Fax: City: State: Phone No. -A9d2 00 G/,2ogl Zip Code: Fax: E-Mail: Ak, Phone No Fill in fee simple Title Holder 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. 7777W Planning&Development Services Department 0 Building&Code Regulations '© •', .o 2300 Virginia Avenue Fort Pierce,Florida 34982 W (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 a I aappl* a e 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 hqw to Z, ee 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 tip licensed in this jurisdiction. If for some reason they do not possess a license,I may be responsible and liaLI r t 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 relatedeeal cost,which could include loss of wages during recovery from their injury. Initial �4 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 Depart t to the Florida S t�Department of Professional Regulation. Signed and acknowledged on this day of of 20 . Owner/Builder Signature STATE OF FLORID COUNTY OF The o eg ing mstru nt was acknowledged before me this day of 20 It , by who is personally known to me,or who has p uced as identification.71607 f�i{ a • yamp#Rey Signature offNary Ty or Print Name of Nota y (Seal) Title:NotaKy P bblic Commission Number SLCPDSD Revised 05/15/2014 wK.;�v�wM roce+� ti�I:y 's AUDREYB.HUMPHREY MY COMMISSION a FF 174772 EXPIRES:March 6,2019 Rt dt`` aonded Thru Notary Public Underwriters a