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Home My WebLink AboutSUBMITTED PAPERSdata• Fee Due: � i Plana Building 4 ❑ Electrical ❑ Plumbing ❑ Shed ❑ Demolition Seepage 2 for instructions and Al"on/Site Address: r a� ID Number: rermlt it ig & Development Services Code Regulations Division 2300 Virginia Ave. Fort Pierce, FL 34982 (772)462-1.553 . SALTY PERdMIT APPLICATION SCANNED By 0 Gas ❑Siding � ° �Uc/e COLIM,Y paperwork required for specialty permits e 740 0ri J e 00S- 000- Ofrlce Use Only Section Township Range Map Page Zoning Land Use Initials a•nr Complete Description of Project or Work: ,loners Information 5. Contractors Information Name: /�- U_SS ell 11�aSD n FL Reg/Cert #: Address: ��%/'% 1r%� �/�'l e �r�� J County Cert#: City: / % e r[7 State: F/, Zip: Q Phone: I /W 6. Value of Construction: $ 2SO- W . OWNERS AFFIDAVIT: I certify that all of the informs compliance with all applicable Business Name: 6 5 AaIO Phone: PRINT OWNER OR CONTRACTORN ' STATE OF FLORIDA, COUNTY OF ACKNOWLEDGED BEFORE ME THIS DAY OF WHO IS PERSONALLY KNOWN TO ME OR WHO R� LAS IDENTIF T[ON.. 1 SIG OF NOT COMMISSION NUMBER Fax: ontained in this application is correct and that all work will be done in regulating constriction and zzo\ni�ng. �SIGNATU�REOFO RWRE OROTV RACTOR 20 BY UCED DAWN M(tW . Notary Public - State of Florida •y : My Comm. Expires. Mar 22, 2017 Commission # EE 877571 . �i '�•%��•'Bonded hrou h NOTICE TO OWNER: FAILURE TO RECORD A 40TICE OF COMMENCEMENT - h IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, C LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE_ OF COMMENCEMENT. EXEMPT: A/C -HEAT REPLACEMENTWIT11 CONTRACT UNDER $7500.00 Revised 04/26/2010 FOR YOUR NOTICE TO OWNER: FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR RVIPRO\ -71NTS TO YOUR PROPERTY. IF YOU INTET 70 OBTAIN FINANCING, CONSULT WITH YOUR I.ER OR AN ATTORNEY BEFORE RECORDING'_ )IZ NOTICE OF COMMENCEMENT. EXEMPT: Ax-HEAT REPLACEMENT WITH CONTRACT UNVJ�R $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 2. Parcel ID Dumber 3. Description of Project or Work Activity i 4. Owner Information Indicate the street address or general location of property where the building activity is taking place. Indicate the tax identification number of the property where the building activity is taking place. Fully describe the activity to take place. 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 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 heightof fence and type of fence ® Siding Attach2 copie's 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"p`rocessing.after 4:30 P.M. For assistance in completing this application, please call (772) . 462;.1553:, during,regulai ,office hours. (8:00 AM - 5:00 PM), Monday through Friday. NOTE: Emergency eleciric 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. State law requires construction to exemption to that law. The exemption allc though you do not have a license. You m may build or improve farm outbuildings, a under $75,000.00. The building or residen improved for sale or lease. If you sell or le; one year after the construction is complete, or lease, which is a violation of this exempti to supervise people working on your builfi have licenses required by state law and by responsibility for supervising work to a lic4 Any person working on your building who employed by you, which means that yot compensation for that employee, all as presc ordinances, building codes, and zoning regul I understand that the building the minimum code. , z. Planning & Development Services Department Building & Code Regulations 2300 Virginia Avenue Fort Pierce, Florida 34982 (772)462-1553 - AFFIDAVIT DISCLOSURE STATEMENT 489.103 (7) EXEMPTIONS done by licensed contractors. You have applied for a permit under an you, as the owner of your property, to act as your own contractor even t provide direct, on -site supervision of the construction yourself. You te-family or two-family residence or a commercial building at a cost of must be for your own occupancy. It may not be built or substantially ;e a building you have built or substantially improved your self within le law will presume that you built or substantially improved it for sale n. You may not hire an unlicensed person to act as your contractor or g; it is your responsibility to make sure that people employed by you :ounty or municipal. licensing ordinances. You may not delegate the ised contractor who is not licensed to perform the work being done. s not licensed must work under your direct supervision and must be must deduct F.I.C.A. and withholding tax and provide workers' ibed by law. Your construction must comply with all applicable laws, Lions. Initial and inspectors are not there to design or give advice on how to meet Initial "— I understand that as an owner -build 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 4ny 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 Iia le f r the cost of the license. Initial I understand that if any person that 's unlicensed and uninsured gets injured on my construction project - they may be entitled to workmen's compens 'on. I could be held liable for. all doctor, lawyer and relat me ical cost, which could include loss of wages durin recovery from their injury. Initial To qualify for this exemption under permit application and initial the above. - I hereby acknowledge that I have understand that any violation of the terms MZing Dep ent to the Florida State e ay of of 20 STATE OF FI COUNTY OF by Sig —nature of Notary Title: Notary Public SLCPDSD Revised 07/22/2010 subsection, an owner must personally appear and sign the building id and understand the above disclosure statement and that I further the ownerlbuilder exemption shall be reported by the Building and tment of Professional Regulation. Signed and acknowledged on this NNW a FROMM 1 me this a day of 20 A' vho is personally kno to me, or who has as identification. Name of Notary •,,, :,,; % MILONE Number .•moo`"a� YOe '' „`� Notary Public -State of Florida • x ; • My Comm. Expires. Mar 22, 2017 �'•��OF F�••o•�• Commission # EE 877571 �� Bonded Through National Notary Assn. WATER- MUCIEZ TIL1TIES-P.O"".- ..-,;x--128, FT TI9RCE FL 1408!" OUNTY'UTILITIES .COUNTY —SEWER RES METER SZ. A $ :oD, 1-I)EP SECURIT, v SERVICE FEE-'z..:. SAME DAY FEE SUB IV SION OVERTIME FEE 434"00 METER -&§TALL.,' CFC/WAT-ER' �k ac FPUMOVE PHO 4' IN/CLP $INq.PA7 CFC/SEW.EW' request im kitliorizes the: Utility to -render Jwker;i�/ot sewage disposal TA R' RE GUA S: t I d kirvi th- tdims; .-F "P ;LATERAL rules a dJgu atiOns,4 promptly OT a r In& ife,mqdp' apart of this coj NEGOTIABLE DRTRANS ee'raies1-:':,