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iST ho 01 Ga-11D-1 Planning&Development Services Department '�v� •�a�
COUNTY Building&Code Regulations
t R I t A 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
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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.
IfgY P ou sell or lease a building you have built or improved within one year after construction is complete, then a
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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 'cable
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
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 liabl for the
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 related medical
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
Zoning Department to the Florida State Department of Professional Regul��igned-and a4nowledged on this
! day of of 20
:Owner—[Buil—der Si - e
STATE OF FLORIDA,
COUNTY OF S `
The foregoing instrume as acknowledged before me this day of ,20(—)—,
by who is personally known o me,or who has
produced)—k— •1 as identification.
gna a of Notary Type or Print Name of Notary (Seal) _
Title:Notary Public Commission Numberw
LASHAHNA INGRAM
Notary Public-State of Floi a
SLCPDSD Revised 05/15/2014 `*-E My Comm.Expires Dec 9-0,
Commiss or,
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LEGEND LEGAL DESCRIPTION:LOT 3,BLOCK 8,FT,PIERCE m E
SHORES UNIT THREE ACCORDING TO THE MAP OR u
BLOCK COR BM =BENCHMARK IR =IRON ROD R =RADIUS OF CURVE PLAT THEREOF AS RECORDED IN PLAT BOOK 9,PAGE(S)
FNb 5/8"IR NO ID LOT I (C) 2 CALCULATED LB =LICENSE BUSINESS L =LENGTH OF CURVE 19,PUBLIC RECORDS OF ST,LUCIE COUNTY,FLORIDA.
5 2',E 0.30' (OCCUPIED)
6.88) cl 'CURVES INFORMATION
TION (M) =MEASURED DISTANCE 3
CL =CENTERLINE NAVD =NORTH AMERICAN VERTICAL DATUM x 3. =SPOT ELEVATION ADDRESS:2506 TAMARIND DRIVE , u�d e
OHE =OVERHEAD ELECTRIC pry FORT PIERCE,FL.34949 o $
CLF =CHAIN LINK FENCE 1n
S 0°00'00"W 110.11' (C) OR =CONCRETE MONUMENT (PC) °POINT OF CURVATURE Q�sQ =CABLE TELEVISION RISER h<;
PK =PARKER KALON NAIL NOTES: Q'31 t" o;
S 0'10'11"W 108.02' (M) COVP =COVERED PORCH R&C =ROD d CAP DRAINAGE FLOW N H 3 k;
CS =CONCRETE SLAB R/W =RIGHT OF WAY SUBJECT TO ANY APPLICABLE EASEMENTS, ;w
EL =ELEVATION ST =SEPTIC TANK x.xx =PROPOSED GRADE RIGHTS-OF-WAY,OR OTHER RESTRICTIONS OF O t"6i�-
EP =EDGE OF PAVEMENT TP =TRAVERSE POINT = T IRON ROD d CAP RECORD. 2 ��
FFE =FINISH FLOOR ELEVATION UE =UTILITY EASEMENT V v&h
FND 4X4 CM FND =FOUND WD/F =WOOD FENCE "LB 4942" A SEARCH OF THE PUBLIC RECORDS HAS NOT BEEN J W dw$+H
ID =IDENTIFICATION WM =WATER METER =WOOD POWER POLE MADE BY THIS OFFICE. �' u
NO ID IP =IRON PIPE A =DELTA OF CURVE 3
ELEVATIONS ARE iN FEET AND RELATED TO ST.LUCIE
S 0°00'00"W 94.73' (C3M) 1 LOT 9 GIS BENCHMARK,D-307 HAVING A PUBLISHED
/FT PIERCE SHORES UNIT 3 1 1 (OCCUPIED) ELEVATION=1.02(FEET)NAVD 1988.
BM I I 1 FFE=6.88 BEARINGS SHOWN HEREON ARE BASED UPON AN
BLOCK 8 ASSUMED MERIDIAN,ALONG THE NORTH PROPERTY
TP SET PK '6� NO SEPTIC OR WELL LINE OF LOT 3,HAVING AN ASSUMED BEARING OF N
EL=2.83 NAVD CL tib LOT Z 60-0 1 6'WD/F COR INTERFERENCE WITHIN 75' 90°00'00"E.ALL OTHER BEARINGS ARE RELATIVE
bA ti b (VACANT) 1 N 2.3',E 0.20' THERETO.
'L• 1, ti N 90°00 00"E 161.52' CSM '� - n X x— PROPERTY LIES IN F•I.R.M.ZONE"X 6 AO DEPTH 1"',AS
30' T�3 '
' SHOWN ON MAP NUMBER 1211100181 J,DATED 02/16/16.
EP EP a Gm FLOOD ZONES ARE APPROXIMATE AS SCALED FROM 0
JJ4 I ;'„1, 1 m1 FLOOD INSURANCE RATE MAPS.
N3Vl l'4t-LOT 3 1 N IN ACCORDANCE WITH CHAPTER 5J-17.051,ADDITIONS
�„ OR DELETIONS TO SURVEY MAPS OR REPORTS BY(VACANT) 1 ^' OTHER THAN THE SIGNING PARTY,IS PROHIBITED n NI WITHOUT WRITTEN CONSENT OF THE SIGNINGs60.36- (p 1PARTY. pCE" CS .91 1 w;1� LOT 8 THERE MAY BE ADDITIONAL RESTRICTIONS THAT ARE Q 4=
tib ti, 1-b 3e.9z' 1 1 A� (OCCUPIED) NOT SHOWN ON THIS SURVEY,THAT MAY BE FOUND F <z
p^, 0qa 28.00 5 9+ FFE=4.77 - IN THE PUBLIC RECORDS OF ST.LUCIE COUNTY, 4
p ,y. %. 13.0 PROPOSED 9 770 SQUARE FEET <OI FLORIDA,
ra 5INGLE FAMILY 1 r
T DRAINFIELD
3 w 0.ESIOENCE Q31 NOT VALID WITHOUT THE SIGNATURE AND THE
- p CONCRETE Q FFE:5.00 6492' N SEPTIC TANK ORIGINAL RAISED
o• DRIvE P 0, 56.42' 11 'O PUMP SYSTEM SURVEYOR AND MAPPER.OF A FLORIDA LICENSED ;
A p cs a I C1�w A- G 1 ) LEGAL DESCRIPTION FROM WARRANTY DEED 0
W 2133. 1923 SQVARE FEET 1 RECORDED IN OFFICIAL RECORD BOOK 3539,PAGE 1913, m
S9 O v — ��� GREENAPEa t SAINT LUCIE COUNTY PUBLIC RECORDS.
S PROPOSED WATER _ 6'WD/F d 3'CLF COR
SERVICE °00 _ 6L5 ' C_ N 1.5,E 0.30' BOUNDARY 6 TOPOGRAPHICAL SURVEY FIELD DATE:
�tio T•ti te`
5'CLF L0R ,6'! 1' 09/l2/16.
N 1.5' I 1 LOT 7PUBLIC WATER AVAILABLE.
EP EP ti� 5'TO 3'CLF + 0 (OCCUPIED) CERTIFIED TO: TERRY L. STURGELL;
DLOT 4 la. 1 FFE=6.08 CHRISTENSEN FINANCIAL INC. ISAOA,
CL�.(PC)/ S 0°00'00"W 18.66' (C) (OCCUPIED) 1 �', 1 NO SEPTIC OR WELL ATIMAI FIRST INTERNATIONAL TITLE.
NOT FND FFE=3.82 1 N INTERFERENCE WITHIN 75'
NO SEPTIC OR WELL
1
Cl INTERFERENCE WITHIN 75' ' of �.,
WM 1 V .. s a
tNOT
NO ID CURVE CHART O LOT=15,188 SQUARE FEET=100%.
G
Cl � HOUSE,GARAGE,ENTRY 6 COVERED PATIO=3,444 SQUARE FEET=237.
R=939.39' (C), 939.39' (M) to CONCRETE PADS=264 SQUARE FEET=0.27. 0.G_SANTOIEAIMA
r DRIVE IN LOT=839 SQUARE FEET=67, AA?LT2°E M -
A=4°16'40"(C),4°18'29"(M) per. OPEN SPACE=10,641 SQUARE FEET=707. _R._KEMERSON
L=70.14' (C), 70.63' (M) LOT 5 1 30'
C2 (OCCUPIED) WE:
-7
09/13/16
R=939.39' (C) ne o new,o<c.s
4=5°50'34"(C) PLANs
COR L= 95.80' C9,16-133'7' "�•'"`"
ND ( ) FND t"IP NO ID ROBERT F.KEMERSON
1 - PROFESSIONAL SURVEYOR AND MAPPER
STATE OF FLORIDA(PSM)#6285 I s"OF-1
F:\Projects\1640BS\16-133\16133 BNDY.dwg,BNDY-TOPO,9/14/2016 2:23:25 PM,V¢Iwn Group,Inc.,(772)079.0477