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Home My WebLink AboutMisc Letters oil tr CITY OF FORT FLORIDA hum 5 BUILDING DEPARTMENT APPLICATION FOR BUILDING PERMIT 2004 (772)460-2200 EYE 261 OR 276 FAX(772)467-9836 C *Property Address 2-2-OLI P10cn.- *Dat�l 143 %1*#of plans submitted 4 of CD's submitted Parcel]D#9A%4(p o q o raci #M4-AAM x# (Located on your lax bill) Email Address cell# *Owner Name ",\ev"A *Owner Address zz;.ZA, Type ofpermit *Valuation S Z *Description of Work C�' \.2— Architect: �ol PhoneC ..... Fax i Email Address Engineer *.)b;--4i SVC, Z,--VFax Phone( r_-1CW fir" V-deft-.b.% Email Address I *CONTRACTOR/APPLICANT INFORMATION:City License# State License Company Name QuB)ffier Address' C' tate 0(\ Phone# Cell# Email Address SUBCONTRACTORS:See Subcontractor Verification Sheet It may be Required to accompany this application 1 09 Occupancy Construction Type #Of Units #of Stories Sq.Ft Conditioned Space Total Sq.Ft. JUL 0 @fj1&_a (FIRM) 1An a Special Flood Hazard Area(floodplain)per the current Flood Insurance Rate w,Map El Yes g"` mawn inert > D's co ZC;a4.,-.00 t must include certified elevation information on a FEMANFIP Elevation C catc. r_� .,-* e0ifi J b mil ied until a Certificate of Occupancy/Certificate of Completion has been issued ed after inspection by e I under .%?MZD� be cup U final in ti n th 0 e with the building code, city and state ordinances and other applicable rules and regulations. I am also ve gthap, s so d idePtical t - Owner I I ture 0 AVA r Signature of Property Ov State of Florida-County of State of Florida,,County of AT=ed to and subscribed before me this Affirmed to and subscribed before me this 20 by I 12CL—,by person 13,known to me or who has.?pRa ersonally known to me or who has produced as identificatio as identification. u Notary Signa -7 Notary Signature: Notary(print name) CI<otary{print name) Construction documents must accompany this application. The Florida energy code submitted becomes an integral part of this plan and must pass final inspection. "Notice: In addition to the requirements of this pennit,there may be'additional restrictions applicable to this property that maybe found in the public record of this 'coiinty, and there may be additional-permits--required -from otlaer. governmental..entities such.aR,-waste management district- state agencies, DI''federal agencies."SIGNA= OF TEE APPLICANT MUST BE NOTARIZED- If owner builder, applicant must sign in person.BUILDING PERMIT includes:Building, Electrical,Plumbing,Mechanical,and Sewer only. All other trades require separate permits. 'Required Information. Asbestos compliance: It is the oyrner's or operator's responsibility to comply with section 469.003, Florida Statutes,i and to notify the Department of Environmental Protection of his or her intentions to remove asbestos,when applicable,in accordance with state and federal law. OFFICE USE ONLY, *1�_ =7 FEES: *See the break Down Tee Sheet le' . ' Total Fees Due Remarks Reviewed by Date _?4-O 7 Building Of1i �rs tom, G drivelbuildirig/famis/application PIVRF117- SUNK ,I , � 1 ['I T Y If 11kT 'FlIER [E � it /�y p) /y �-- DEPARTMENT OF BUILDING AND COMMUNITY RESPONSE ' P.O. BOX 1480 • FORT PIERCE, FLORIDA 34954''' TEL. (772)460-2200 FAX(772)467-9836 it I� OWNED BUILDER OR CONTRACTOR AFFIDAVIT (I Asper City Ordinances 16-22, 16-46, 16-48 and Florida BuildW g Code S.,550-9,a rid As a condition of'obtaining a virfor constrncdozv.repak orrenovation'prop 0-1-4 � i C®*nactor: - rte I understand and accept full responsibility for the prompt removal of all debris andi construction materials from the property for which I am seeking to obtain a buildin a� � permit in accordance with the Code of Ordinances of the City I Initials I I agree that no debris or construction materials will be placed on any public proper or on any public right-of-way except as may be specifically authorized*by tine Code of ) Ordinances. §! initials i I further understand that prior to a final inspection for the project completion or issuance of a Certificate of Occupancy(or Certificate of Completion),all debris an construction materials shall be removed from the property or the Inspector will not approve the final inspeetiopn.Additional reinspection fees shall apply. I Initials s ! I understand and accept full responsibility for debris*removal at my own ezpeuse lin accordance with the City Code ofOrdinances. Initials _ _.__ nts and I further . I-hereby-acknaowled a that ihave.read and,under stand the above stateme„ understand that any violation of the terms of this atfiidavpt sinail be reported io; l e City of-port If Pierce Department of Building aped.CCommunityResponse for action' and possible"stop work" order under the issued permit. Date Contractor or OwnerlBuilder's Signature (Rev 511W05) I E l I i� I f ,- CITY OF FORT PIERCE BUILDING DEPARTMENT ' oT.Pl�igc 100 N. US #1;Fort Pierce,Florida 34954 Phone (772) 460-2200 ext. 276,261,214 Fax(772) 467-9836 " OyVNERBUILDER AFFIDAVIT SVNRI_ 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 supervise the construction yourself. You may build or improve a one-family or two-family residence or a farm building. You may also build or improve a commercial building at a cost of$25,000 or less. The building must be for your own use and occupancy. It may not be built for sale or'lease. If you sell or lease a building you have built yourself within one year after the construction is complete,the law will presume that you built it for sale or lease,which is a violation of this exemption. You may not hire an unlicensed person as your contractor i It is your responsibility to make sure that the people employed by you have license required by state law and by county or municipal licensing ordinances. Any person working on your building who is not licensed must work under your supervision and must be employed by you,which means that you must deduct F.I.C.A. and withholding tax and provide worker's compensation-for that employee,.all as prescribed bylaw. Your construction must comply with all applicable laws,ordinances,building codes and zoning regulations. To qualify for this exemption under this subsection,an owner must personally appear'and sign the building permit application. P 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 QJficial to the State of Florida Department of Business and Pro ess'onal Regulation. Signed and acknowledged on thisday of 200 Ae Owner/Builder Signature STATE OF FLO COUNTY OF ��L The forego'ng`histrument w,as�ackuQo v edged before me on this day of " 200 b �� 1C��'� � who is personally know to me or who has producedlif-1 ntificati M. `�� SUg � �.�� •`eon er V,.� ure of Notary 004-0 � Orc9•�� I / — p ¢ , Type or Print name of Notary Mi&p gm gMARY PUBLIC TITLE OR'DA�+ --\ COMMISSION NUMBER "Disclosure Statement:State law requires asbestos abatement to be done by keens ed 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 asbestos abatement contractor even though you do not 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 andllthe building is not for sale or lease or the building is a farm outbuilding on our property. If,you sell or lease such building ° within 1 year after the asbestos.abatemeit is complete,the law will presume thai'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 make sure that people employed by you have licenses required.by state law an'i by county or municipal licensing ordinances." i it floor", ,. CITY OF FORT PIERCE BUILDING-DEPARTMENT;ROUTING FORM July 3,2007 LJUL - 'd E Permit#: 07-00000874pgt _ r Owner Name: Mildred Waithe (TR) R007 " Property Address: 2204 AVP Type of Permit: STORAGE SHED CIT'OF FORT PIERCE,FLOI Planning: ApproVedA4Approved as Noted ❑ Rejected ❑ N/A ❑ Historic: Individually Designated ❑ District ❑ -A ,pproved ❑ Approved as Noted ❑ Rejected ❑ N/A Arch Design: Approved ❑ Approved as Noted ❑ Rejected ❑ N/A Wl- ` Landscape: Approved ❑ Approved as Noted ❑ Rejected ❑ 110EIVED By DOG,C'E", Comments: nil 1721,07 !RON,, p 19(c Zonin � i'�_ (2,a� Calculations (Road) CP I Land Use Fee per Unit Impact Fee #Units P X #Sq. Ft X _ d Calculations (School,Parks, Library, Public Bldgs) #Units x = l #Sq. Ft X Impact fee credits due to change of use or previously demolished buildings: $_i ,e Road Impact Fee: Road Impact Fee: Road Impact Fee: School Impact Fee: School Impact Fee: School Impact Fee: Parks Impact Fee: Parks Impact Fee: Parks lmpact Fee: Library impact Fee: Library Impact Fee: Library Impact Fee: Public Bldg Impact Fee: Public Bldg Impact Fee: Public Bldg Impact Fee: Fire/EMS Impact Fee: Fire/EMS Impact Fee: Fire/EMS Impact Fee: Law Impact Fee: Law Impact Fee: Law ImpactFee: Impact Fee Credit: TOTAL IMPACT FEE: I' j, ii, CITY OF FORT PIERCE �I BUILDING DEPARTMENT SHIED FORM (772) 460-2200 EXT 26108 276 ,. FAX(772) 467-9836 `Owner Name � r-ti Property Address L 1 �• ' Total SgFt of Primary Building_CY-11 # of Accessary u gs Total.SgFt VZI Indicate if More Than One Structure is on Site if Yes Show it. I %A zzCl r ! I NOTE I ' A— "A", „B„ AND TIC" SET PROPOSED BACK AS PER SHED LOC _ ' ' B= CITY CODE "A" CAN BE BIGGER ! f C= THAN "B" OR"C" ,�_ I JN SHED SIZE I G- EXISTING STRUCTURE Y - X OR HOUSE i I� SHED COULD BE PLACED. ON OPPOSITE SIDE OF I r PROPOSED LOCATION, IF J ;I DESIRED. I � or h I N EXISTING DRIVE A i �i PLOT FLAN V=20' SCALE STREET NAN4E t I i � k I ; �_ ff to I