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HomeMy WebLinkAboutSUBMITTED PAPERSFee Due: 7 Permit # Planning & Development Services Building & Code Regulations Division 2300 Virginia Ave. Fort Pierce, FL 34982 (772)462-1553 St. SPECIALTY PERMIT APPLICATION ❑ Electrical ❑ Plumbing ❑ HVAC ❑ Fence ❑ Shed ❑ Demolition ❑ Gas ❑ Siding sC$y�CJJ Lucie Count Seepage 2 for instructions and add dojnaal p/aperwork required for specialty permi ts 1. Location/Site Address: 5 / ®� / I `� /r�/ f / "V--- 2. Parcel ID Number: -ff 3 7' ©5 ® 56 d —?c7lo ` a6 f 3. Office Use Only Section Township Range Map Page Zoning Land Use Initials Description of Projector Work: OF Le I / AC- 4. Owners for at n •{ J 5. Contractors Information Name: c� � ,� FL Reg/Cert #: Address:* County Cert#: City: Pl e"c - State: Business Name: Zip: 3 41'-�ra -�,- Phone: `fm,-370"6295de• 6. Value of Construction: $ 40 '7 ' a LOIN C Fax: M OWNER'S AFFIDAVIT: I certify that all of the information contained in this app cati is correct and that all work will be done in 2 compliance�+ all applicable laws regulating construe ' and zoning PRINT OW&ER OR CONTRACTOR NAME SIGNATURE OF OWNS OR CONTRACTOR STATE OF FLORIDA, COUNTY OF f'y/ y ii ii A 1 (� ACKNOWLEDGED BEFORE ME THIS DAY OF ✓ %�L.� 20 )3 BY U� D N =) WHO IS PERSONALLY KNOWN TOME OR WHO HAS PRODUCED AS IDENTIFICATION (seal) GNATUREt NOTARY tYPE OR PRIN7NAME OF NOTARY COMMISSION NUMBER NOTICE TO OWNER: FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR . LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. EXEMPT: A/C -HEAT REPLACEMENT WITH CONTRACT UNDER $7500.00 Revised 04/26/2010 �Y P1 AUDRfYB. HUMPHREY� = li MY COMMISSION # EE 061159 ';;:o;' EXPIRES: March 6, 2015 pf ;°�` Bonded Thru Notary Pu611c Underwriters p� f NOTICE TO OWNER: FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. EXEMPT: A/C -HEAT REPLACEMENT WITH CONTRACT UNDER $5,000. INSTRUCTIONS Please complete all information in the space provided. All information must be printed (use black or blue ink only) or typed. This permit application is to be used only for those activities that are not otherwise included under a primary building permit. This application may not be used for any activity that includes structural alteration. The information to be provided with this application includes: 1. Location/Site Address Indicate the street address or general location of property where the building activity is taking place. 2. Parcel ID Number Indicate the tax identification number of the property where the building activity is taking place. 3. Description of Project or Work Activity Fully describe the activity to take place. 4. Owner Information Indicate the name and address of the owner of the property on which activity is taking place. 5. Contractor Information Indicate the State of Florida registration number (if applicable), St. Lucie County contractor license number and the name of the business doing the work.,,:, 6. Value of Construction Indicate -the total value of the work•to take place. Total cost of construction includes all current retail material and labor costs associated with the building/construction activity. Construction -value -is - used to determine the permit fee. St. Lucie County reserves the right to question and/or modify the 'indicated value of construction. if it is demonstrated that the submitted figures are riot consistent with similar types of construction: ❑ Gas Attach 2 piping schematics with tank size, location, and BTU of each appliance ❑ Shed: Attach 2 plot plans, 2 copies of DCA letter and plans, 2 anchor specifications ❑ Fence Attach 2 plot plans showing location of fence height of fence and type of fence ❑ Siding Attach 2 copies of manufactures specifications ❑ HVAC Attach 2 residential energy studies, 2 manual J calculations. 2 sets of duct layouts for new system or full replacement This application can be submitted to St. Lucie County Building and Zoning, 2300 Virginia Avenue, Fort Pierce, FL 34982. All permit applications must be filled out completely before submission. No applications will be accepted for processing after 4:30 P.M. For assistance in completing this application, please call (772) 462-1553, during regular office hours (8:00 AM - 5:00 PM), Monday through Friday. NOTE. Emergency electric service change out inspections will not be performed after 3: 00 PM without special arrangements and additional fee paid. Upon issuance of this permit, required inspections can be scheduled by calling (772) 462-1261. Planning & Development Services Department Building & Code Regulations 2300 Virginia Avenue Fort Pierce, Florida 34982 (772)462-1553 OWNER/BUILDER 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 or a commercial building at a cost of under $75,000.00. The building or residence must be for your own occupancy. It may not be built or substantially improved for sale or lease. If you sell or lease a building you have built or substantially improved your self within one year after the construction is complete, the law will presume that you built or substantially improved it 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. Any person working on your building who is not licensed must work under your direct supervision and must be employed by you, which means that you must deduct F.I.C.A. and withholding tax and provide workers' compensation for that employee, all as prescribed by law. Your construction must comply with all applica I ws, ordinances, building codes, and zoning regulations. InitiaA I understand that the building official and inspectors are not there to design or give advice on ho to eet the minimum code. Initial 4 1 understand that US W1 0WHOL-buildei that kuiy contiact disputes vyith sub-COntractas and I must be handled in a civil court with the advice of an attorney. This department will not mitigate any contract disputes. Initialf, 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 maybe responsible and lia or 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 relate dical cost, which could include loss of wages during recovery from their injury. Initial L 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 disclo re statement and that I further understand that any violation of the terms of the owner builder exemption sh be eported by the Building and Zoning Department to the Florida St t Department of Professional Regulatio S' ed and acknowle on this 1\ day of 7 ?M/ G of 20 . Owner/Builder Signature STATE OF FLORIDA _ COUNTY OF (� The foregoing ins ument was ac owl a efore me this � �` day of G�I,L h 20 2 ; by 1JVI_ {7i (� �( ( who is personally known to me, or who has nrnAi X /)i. /7 A - r UA - C as identification. A ure fTtt Type or Print Name of Notary (Seal) Notary Commission Number OypY Pip/,,' SLCPDSD Revised 07/22/2010 ti AUDREY B. HUMPHREY MY COMMISSION # EE 061159 ;as EXPIRES: March 6, 2015 f,4°'° Bonded Thru Notary Public Underwriters Property Appraiser - St.Lucie :7-7111ty, FL Page 1 of 1 PROPERTY RECORD CARD Cynthia Greenway Record:1 of 1 «Prev Next » Spec.Assmnt Taxes Exemptions Permits Home Print Property Identification �VAECO Site Address: 5701 MELVILLE RD ParcellD: �34002:02906 G2 Sec/Town/Range: 10 :36S :40E Account* 39288 y Map ID: 34/10N Use Type: SF Res s Zoning: RS-3 City/Cnty: St Lucie County Ownership and Mailing Legal Description Owner: Cynthia Greenway Raymond Sloan WHITE CITY S/D 10 36 40 FROM NE COR OF LOT 230 RUN S 50 FT, Address: 5613 Melville Rd TH W 152.65 FT FOR POB, TH S 133.07 FT, Fort Pierce FL 34982 More... Sales Information Assessment 2012 Total Land and Building Date Price Code Deed Book/Page 2012 Final: 27600 Land Value: 8100 Acres: 0.2 2/22/2013 24000 0001 WD 3489 / 0809 Assessed: 27600 Building Value: 19500 5/5/2011 0 0119 PR 3293 / 1858 Ag.Credit: 0 Finished Area: 675 SgFt 1/1/1900 0 / Exempt: Taxable: Taxes: 558.37 BUILDING INFORMATION faro) (m) Exterior Features View: - RoofCover: TG - Tar & Gravel RoofStruct: GA - Gable ExtType: HD -HD YearBlt: 1959 Frame: - Grade: D - D EffYrBlt: 1976 PrimeWall: BP - Cone Block StoryHght: 0010 -1 Story No.Units: 1 SecWall: VS - Vinyl Siding Interior Features BedRooms: 2 Electric: MX - MAXIMUM PrmintWall: PB - PANEL BOARD FuilBath: 1 HeatType: - AvgHt/Fl: 1/2Bath: 0 HeatFuel: - Prm.Flors: CA - A TUCON %A/C: 0 %Heated: 0 %Sprinkled: 0 Special Features and Yard Items Land Information Type Y/S Qty. Units Qual. Cond. YrBlt. No. Use Type Type Measure Depth FEN4 - CHAINLINK 4' Y 1 380 AV AV 1990 1 0100-SF Res BI -Front Ft 63.84 133 THIS INFORMATION IS BELIEVED TO BE CORRECT AT THIS TIME BUT IT IS SUBJECT TO CHANGE AND IS NOT WARRANTED. http://www.paslc.org/paslc/prc.asp?prelid=340350202960606 3/14/2013 Planning & Development Services Department Building & Code Regulations Division 2300 Virginia Ave Fort Pierce, FL 34982 772-462-1553 Owner Builder Affidavit — Electrical Contracting DISCLOSURE STATEMENT F.S. 489.503 (6) EXEMPTIONS State law requires electrical contracting to be done by licensed electrical 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 electrical contractor even though you do not have a license. You may install electrical wiring for a farm outbuilding or a single-family or duplex residence. You may install electrical wiring in a commercial building the aggregate construction costs of which are under $75,000. The home or building must be for your own use and occupancy. It may not be built for sale or lease. If you sell or lease more than one building you have wired yourself within 1 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 electrical contractor. Your construction shall be done according to building codes and zoning regulations 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. Failure to do so may result in a liability for you! To qualify for this exemption under this subsection, an owner must personally appear and sign the building permit application. I hereby acknowledge that I have read and u further understand that any violation of the terms of Community Development Director to the Florida Stal acknowledged on this -j q- day of d the above disclosure statement and that I r/builder exemption shall be reported by the ment of Professional Regulation. Signed and NO 20 / "5 . . OWNEWBUILDER SIGNATURE STATE OF FLORIDA r COUNTY OF "w i/ The foregoing instrument was acknowledged before me this /7/ day of`�/ -e by �-;Iet CJ -11) , who is personally known to me or has o uced L ,`� ` as identi ication. Cr aarW�� Signature of ofa int name of Notary' Title: Notary Public Commission Number AWREY I. Hu PHREY 1,xrp MY COMMISSION # EE 061159 SLCPDSD Revised 7/23/2010 P - EXPIRES:Marah6,2015 '• Bonded7hru Notary PUhrf Underwriters St. Lucie County Owner Builder Affidavit -Electrical Contracting P,f,