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Home My WebLink AboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: <\ \(O Permit Number:v�'O"\-ad�1 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 PERMIT APPLICATION FOR: R M.05S5D INP' OVEMENT L� ATION, ,moi Address: e WO6 r—� 1 �evCf- F1 3 �l Legal Description: Property Tax ID#: 13V- 701- 00-57!J- 000 -7 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: D TAILED DCS.aRl _T 0 OF WO'R�K: leemoyt .l �� c�a'hese dn„ gall C�® STR CTIO IM ORMATIFOX Additional work to be performed under this permit-check all that appy: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Electric _Plumbing _Sprinklers _Generator _Roof Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction: $ Utilities: —Sewer —Septic Building Height: o N /LSSRI EIM,IRS Name 0 : ' Name:-'... Address:c15-27 Lat462l sae . Company City: Ek_ f��errce. State: 4 Address: Zip Code: 3q? ,7 9 Fax: City: State: Phone No. '7 -.33,Z- y767 Zip Code: Fax: E-Mail: Qwa 0 d Court Phone No Fill in fee simple Title Holder on next page (if different E-Mail from the Owner listed above) State or County License J If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTU NLIEN W INF®RMAT ON: 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 per 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 our Notice of Commencement. �i-�r?lL�/yG/ `f!� Signature of Owner/Lessee/ ntractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF S _ Lyc\`Z COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this day of S 2019 by this day of ,20_ by (Name of person ackno edging) (Name of person acknowledging) (Signature of Notary P lic-State of Florida) (Signature of Notary Public-State of Florida) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Pro duced Produced NW��GNENS 23 r �,.�,, # 6 202 Commission No. �� ,��Q1M�SS�oN ommission No. (Seal)ONA o ayolsrl REVIEWS 'FRONT UN61MG SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. Planning&Development Services Department gal 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 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 applicable 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 meet the minimum code. Initial ' 9 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 for the cost of the license. Initial 1111"y 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 ical 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 owneribuilder 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 t of 201 . Owner/Builder Signatur STATE OF FLORIDA COUNTY OF -j9r_LUc\e Th foregoing instrument was acknowledged before me this day of 20`� , 'by�db�� d �� who-is personally known to me;or who has produced 'FL L as identificafion... sa;aM11 �vtYV5 p NpNIARIEwy On023 Signature of Notary Type or Print Name of Notary ,ti:' •,; my'? 1�m 1\6, 20 Title:Notary Public Commission Number 1�D _ :+'- py .'1 � �cunde'""teR :' •:O;A: g0ndeO SLCPDSD Revised 05/15/2014 Planntng8[tevetopmentsenrices ASBESTOS NOTICE TO OWNER/BUILDER Building&Code,Reguta6on Divislan 2300 Virginia Avenue, Fort Fierce,FL,34982 P.honeg721462-2172 Fax:(772)4624443 September 07, 2016 FILE C OPY ROBERT ROGERS 9527 Laurelwood CT Fort Pierce, FL 34951-2933 RE: Building Permit Number 1609-0087 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. Ir-A1174 Leo -7-/ Owner eignature & Date 9/7/2016 10:50:47 AM