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Home My WebLink AboutSUBMITTED PAPERSPla ping & Development Servicbs Building & Code Regulations Division 2300 Virginia Ave. Fort Pierce, FL 34982 (772)462-1553. /3 iz -o3a� SPECULTY PERMIT APPLICATION ❑ Electrical ❑ numbing ❑ HVAC ❑ Pence Sc ❑ Shed 011Demoliition 0 Gas ❑ Siding 19t.�� Seepage 2 for instructions and additional paperwork required for specialty permits Cp4� L 1. Location/Site Address: 2. Parcel ID Number: 3 `f0 D O a^ 0 Office Use Only Section Township Range Map Page Zoning an Use Initials 3. Complete Description of Project or Work: 4. Owners Information 5. Contractors Information Name: A'. a 1 L I �N A-il( FL Reg/Cert #: Address: // n I W I S i County Cert#: City: CF State: 0(- Business Name: Zip: 6. Value of Construction: $ Phone: 5 /L9 /p 0IS j Phone: Fax: owNER`S AFFIDAVIT: I certify that all of the information contained in this application is correct and that all work -will be done in compliance with all applicable laws regulating coristinlctio d z niilg. y A14 %E- !�-64V &ZC PRINT OWNER OR CONTRACTOR (, SI ATURE OF OWNER OR CONTRACTOR .STATE OF FLORIDA, COUNTY OF I ACKNOWLEDGED BEFORE ME THIS 3 r DAY OF 20 BY WHO IS PERSONALLY KNOWNTO ME OR WHO HAS PRODUCED .b L -_:�:� 3-. �J DAWN MILONE 7NTIMATION. ; ptPRY Ppef Notary Public - State of Florida . - E My Comm. POW Mar 22, 2017 TUREOFNOTARY RINTNA1 EOFNOT Y ;, Commission #,EE 877571 °� �� Bonded Through National Notary Assn. 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 $7500.06 Revised 04/26/2010 NOTICE TO OWNER: FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR wRovENmi --,,,To YOUR PROPERTY. IF YOU INTEND To,' "LAIN FINANCING, CONSULT WITH YOUR LENDE, AN ATTORNEY BEFORE RECORDING YOUR ,_�SCE OF COMMENCEMENT. EXEMPT: A/C;41kAT 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 Projector 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 germit_fee. Si. Lucie County___ reserves the right to question and/or modify the indicated value of construction if it is demonstrated that the submitted figures are not 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 El AC Attach 2 residential energy studies, 2 manual d 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 he 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. O Planning & Development Services Building & Code Regulation Division 2300 Virginia Avenue Fort Pierce,'FL. 34982 Phorie:(772)462.2172 Fax:(772)462-6443 December 31, 2013 DANIEL KEENAN 2583 County Highway 37 Fleischmanns, NY 12430-4420 RE: Building Permit Number 1312-0308 ASBESTOS NOTICE TO OWNER/BUILDER e one y icense con rac ors ou ave a.. ied 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. *k Owner Signature & Date 12/31/2013 2:52:26 PM 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 applic ble aws, ordinances, building codes, and zoning regulations. Initial I understand that the building official and inspectors are not there to design or give advice on holy 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 no mi iga a any con a ispu es. 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 lia a fo 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 Dep ent to the Florida State Department of Professional Regulation. Signed and acknowledged on this day of C. of 20. Owner/Builder Signature STATE OF FLORID COUNTY OFJ- T egomg instr en acknowledged before me this l day of by -,� who is personally known to me, or who has z -d Al'-d R i l as identification. Title: Nota _Public SLCPDSD Revised 07/22/2010 rl� on pay E, Type TPrirff lame c Commission Number (Seal) 11-�IN5 WC_nqQ1\