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Home My WebLink AboutBuilding Permit Application i All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: .I• Building Permit Application Planning and Development Services Building and Code Regulation Division i 2300 Virginia Avenue,Fort Pierce FL 34982 ` Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential V/ PERMIT APPLICATION FOR: i PRQPQSED IN ROUEMNT LQCATIQN• Address: ` }� r �O�2 G�.1�SE /�➢ ��1� T- �1 kC�' i—; L �y R Legal Descripjtion:Wh i+-�,_ '4-1, 5I �, o s 3.(� 40 S 1 &'.5 jE rnr ti '?j n Fi- aC L-ay 1.0 L&_s:5 R I LJ a-!T e't-'s" Ad -(. 4_'), 8c. ,3 l-1/y �e'n�-,D 3�/0 5lJ'�� S a 1 Property Tax ID#: -3403 -0 (30 A Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: i ORS . -V-Uh 1 YW rawYi l V_i 3J LI'V b. C�(z Ln �e•,��Je, ( ao� c�e c �t r o�►�,c� \oo�� Q�,oV¢ V\1 � '' 'LI he r- - 1` Uyiicw'f__ d CON'STR'l-1C�SIO. f OR A=1`O' . Additional work to be performea un er t is permit-check all tat appy: Mechanical —Gas Tank —Gas Piping —Shutters Windows/Doors —Electric —Plumbing —Sprinklers —Generator Roof Pitch. Total Sq. Ft of Construction: Sq. Ft.of First Floor,: Cost of Construction:$ Utilities: Sewer —Septic Building Height: me crr �R Name: Address: / U1 Op -r-Du Company: ;! _ CityPT- Pi StateFL Address: Zip Coder q Ct !E�) Fax: City: j State: Phone No. Zip Code: j Fax: E-Mail: Phone No Fill in fee simple Title Holder on nextpage(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. j! SIJP LEIUIENTAL C0 STRUCTI®N LIEN L-W NFQRIVLAT 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 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 commencing work or recording our Notice of Commencement. ignature of Owner/Les-see/Cordractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OFCOUNTY OF The f0going instr ment was acknowledged before me The forgoing instrument was acknowledged before me thi�_day of 20]) by this day of 20_ by (Name o person acknowledging) (Name of person acknowledging) d-WignaEure of Notary Public- ate of Florida) (Signature of Notary Public-State of Florida) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of IdentificationType of Identification Produced LASHAHNAyINGRAM Produced �o,�pK UAB, " Notary Public•State of Florida Commission No. ° _ ; My q®p�l)Expires Dec 20,2018 Commission No. (Seal) N, *o;; Commission#FF 177249 %n0FF°��` Bonded through National Notary Assn. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. i p a` Planning&Development Services Department ® Building&Code Regulations s • 2300 Virginia Avenue 4. 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 ap 1' able laws,ordinances,building codes,and zoning regulations. i' Initial I understand that the building official and inspectors are not there to design or give advice on hmeet the minimum code. ;', Initial o '1 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 VL 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.111i 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 owner/builder exemption shall be reported by the Building and Zonin Department to the Florida State Department of Professional Regulation. Signed,'iiland acknowledged on this Tdayof - of 20) Owner/Builder Signature ZI STATE OF FLORIDA COUNTY OF 'ZX The=instrume was acknowledged before me this day oO ,20 1 , by ,,� who is personally kno to me,or who has produced V�._ as identification. Signature of Notary Type or Print Name of Notary Title:Notary Public Commission Number LASHAHNA INGR D "S� Notary State Public_ AM R ` Dov;<ViY Comm.Expires Dec t Florida SLCPDSD Revised 05/15/2014 y .;or�l.o .�`� Commissio❑ 20'2018 so dad #FF 177249 'i gh Nationat Notar ,iii Y Assn.