Loading...
HomeMy WebLinkAboutBuilding Permit Application All APPLICABL�E�IIINNFO MUST BE)COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 1-' / Lo Permit Number: ©`Yr' R I ' = RECEIVED. Building Permit Application MAY 2 6 2016 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 PERMITA PLICATION FOR: 0xIa J.. -e.vusa -Aex4kc, .rm - �OPEOtENINO �. R ' Address: + v v-i � c (' C e LegalDescription: �6"0 elrr" r 1J a, L Q:i 14 Property Tax ID#: '' 3�vvvvv��J D - Q 0 ol - © © Lot No. Site Plan Name: a 00 1 ✓� �. � � Block No. Project Name, Setbacks F font Back: Right Side: Left Side: .q ,amt m, ' SkYl;.f}Y� ` DET�AI:LED DESS RI'PTI®N OF I � y C 4 C► C;� A_ cz C�/L v C'+ �.1�. C®NSTRl1CTIDN IiN',FQR,I1/IATION: Additional wor to be pertormed under this permit-check all that appy: _Mecha I ical _Gas Tank _Gas Piping —Shutters ` _Wihdows/Doors _Electric _Plumbing _Sprinklers _Generator _Roof Total Sq. Ft of Construction: Sq. Ft.of First Floor:. n1:f Cost of Construction: $ a 0 Utilities: —Sewer _Septic Building Height: ®WNERLE�SSEE: CONTRACTOR; Name ' I S �� G ^z t 2 Name: Address: ,me �3 3 f C�o L, c r^e- Cr Company: City: m i4 S C State: Address: Zip Code: I �1tf 4 5 Fax: City: State: Phone No. %t - D oZ 3 Zip Code: Fax: E-Mail: I j T e IZ ,2 op Co-L, 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 cot struction is 2500 or more,a RECORDED Notice of Commencement is required. S P'P11;$ E T IL�C�`NSTRU�TIOfV�LI'EN L�\UI°/ �FypORMAl"lON {- �a['Y,�.. !'t 4�#Y.r}N: ..�A,AI ! n ".a�1,�e 'Yn:. 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 apermit 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 u intend to obtain financing, consult with lender or an attorney before commenc' ork or recor in our Notice of Commencement. iiiSignature_ f,Owper/Lessee/ o tractor as Agent f3 lx. Signature of Contractor/License Holder STATE OF FLORIDA `°;;o; STATE OF FLORIDA COUNTY OF m COUNTY OF The for oing ins ment was acknowledg d befor ryEg-8 The forgoing instrument was acknowledged before me thi day of 20L by F mg-- < this day of 20_ by v210= a;z ,_-L4ey C QTS (Name of person ack owledging) .�N ` (Name of person acknowledging) 0&6 60 ,�4� - (Signature of N ry Public-State of Florid (Signature of Notary Public-State of Florida) Personally Known .11� OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. /2014 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 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 oI 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 app icable 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 h!!J 1 eet 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 evil court with the advice of an attorney. This department will not mitigate any contract disputes. C C f 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 li e fo he 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 relatical 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 undeistand that any violation of the terms of the owner/builder exemption shall b orted by the i g and Zomng Department to the Florida State Department of Professional Regu04,1 tion. i and acknow edged n this day of of 20 Owner/Builder Signature STATE OF FLORIDAL.,ld COUNTY OF The egoing instrumen was c wledged before me this day of 20 ; by who is personally known to me,or who has produced as identification. i�b J, - A,FNVAL4 eB_ 4u- m-f4R 1� asignature f otary pe or Prin Name of N ary (Seal) Title:No Public ommission Number SLCPDSD Revised 05/15/2014 pUDREV B.HUMPHPEY 174772 ;q?9•PYP`k= MY COMESMarCh g 2019 %�; o ondedP hN Notary POW Under n