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Home My WebLink AboutSUBMITTED PAPERSDate:3 . .1\4 I Fee Due. Receipt# Permit # Trr J Planning & Development Services Building & Code Regulations Division 2300 Virginia Ave. Fort Pierce, FL 34982 (772)462-1553 SCANNED BY St. Lucie County SPECIALTY PERMIT APPLICATION ❑ Electrical ❑ Plumbing ❑ HVAC ❑ Fence ❑ Shed ❑ Demolition ❑ Gas ❑ Siding See page 2 for instructions and additional paperwork required or specialty permits 1. Location/Site Address: 4zlL'el-' �—Tz n �� a 2. Parcel ID Number: / • �� Q�t��' v vy 3. Office Use Only Section Township Range Map Page Zoning Land Use ;Initials of Project or / o / 4. Owners Information r' S. Contractors Information Name: �L�� n ,L �1�G FL Reg/Cert #: Address: /z' e County Cert#: City: 4 - Business NamZFax-:,. Zip:� Phone: < �Ll 4hone: 6. Value of Construction: $ - t OWNER'S AFFIDAVIT: I certify that all of the information contained in this application is correct and that all work will be done in co pliance with all applicable laws regulating construction,And zoning. PRINT OWNER OR CONTRACTOR NA SIGNATURE OF CWNER OR CO RACTOR STATE OF FLORIDA, COUNTY OF �j ACKNOWLEDGED BEFORE ME THIS DAY OF�"• : 20,�, BY WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED ' ZIDEFICATION., " V /04 RE OF NOT6AY lYPE OR PRINT NAME OFINOTARY 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 04/2612010 r'' •. AUDREY O. HUMPHREY MY COMMISSION # EE 061159 EXPIRES: March 6, 2015 Bonded Thru Notary Public Underwriters NOTICE TO OWNER: FAILURE _ _ RECORD A NOTICE OF COMMENCEMENT M....tESULT 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 2. Parcel ID Number 3. Description of Project or Work Activity 4. Owner Information 5. Contractor Information 6. Value of Construction 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. Indicate the State of Florida registration number (if applicable), St. Lucie County contractor license number and the name of the business doing the work. 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 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. Property Appraiser - St.Lucie 0—inty, FL. Page 1 of 1 PROPERTY RECORD CARD Calvin L Shaw Record: 1 of 1 <<Prev Next» Spec.Assmnt Taxes Exemptions Permits Home Print Property Identification � CIE 0Gy Site Address: 4409 SAN DIEGO AV ParcelID: 1431-802-0001-000-6 Sec/Town/Range: 31 :34S :40E Account*: 10917 y� < Map ID: 14/31 S Use Type: SF Res Zoning: RS-4 City/Cnty: Saint Lucie County Ownership and Mailing Legal Description Owner: Calvin L Shaw Michael J Shaw HARMONY HEIGHTS NO 5 BLK A LOTS 1 AND 2 (OR 1238-1079) Address: 4409 San Diego Av Fort Pierce FL 34946-1554 Sales Information Assessment 2013 Total Land and Building Date Price Code Deed Book/Page 2013 Final: 48300 Land Value: 6400 Acres: 0.39 7/21/1999 55000 00 WD 1238 / 1079 Assessed: 48300 Building Value: 41900 7/28/1997 100 01 QC 1098 / 1135 Ag.Credit: 0 Finished Area: 1363 SgFt 4/25/1996 16000 01 QC 1011 / 0026 Exempt: 48300 12/14/1992 0 01 PB 0820 / 0618 Taxable: 0 Taxes: 261.08 BUILDING INFORMATION Exterior Features View: RoofCover: SD - Dim Shingle RoofStruct: GA - Gable ExtType: HD -HD YearBlt: 1956 Frame: Grade: D - D EffYrBit: 1976 PrimeWall: BP - Conc Block StoryHght: 0010 - 1 Story No.Units: 1 SecWall: Interior Features BedRooms: 2 Electric: AV - AVERAGE PrmintWall: PN - PN FullBath: 1 HeatType: FHA - FrcdHotAir AvgHt/Fl: 1/213ath: 1 HeatFuel: ELEC - Electric Prm.Fiors: CU - Carpet %A/C: 100 %Heated: 100 %Sprinkled: 0 Special Features and Yard Items Land Information Type Y/S Qty. Units Quai. Cond, YrBit. No. Use Type Type Measure Depth DWC - Driv-Concret Y 1 720 AV AV 1956 1 0100-SF Res 210 -Front Ft 120 141 UTL3 - UTILITY AVG Y 1 120 AV AV 1999 FEN4 - CHAINLINK 4' Y 1 445 AV AV 1956 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?prclid=143180200010006 3/7/2014 s- Fort Pierc- Jtilities Authority 206 S 6th Street Fort Pierce, FL 34950 CALVIN L SHAW 4409 SAN DIEGO AVE FORT PIERCE FD_-3494.6 USA - Total Amount Received by Receipt Number: Receipt Date: Customer ID: Location ID: PYMT00003945783 3/4/2014 238031 10006337 - -- -- n a er,L' C e zlddr-.s s :-- - - 4409 SAN DIEGO AVE FORT PIERCE FL 34946 USA Cash $60.00 bfPo5-f Fort Pierce Utilities Authority 206 S 6th Street Fort Pierce, FL 34950 On Behalf of: - CALVIN L SHAW 4409 SAN DIEGO AVE FORT PIERCE- F`L_34-9-4_G- Receipt Number: PYMT0000394578 Receipt Date: 3/4/2014 Customer ID: 238031 Location .-- 16006-13% - -RL--Service Address:- - 4409 SAN DIEGO AVE ---_._-FORT PIERCE FL 34946 USA tJ �y G 1iY 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 app�ble 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'OV to meet the minimum code. Initial 4 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. C Initial ` 6� 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 li le 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 relatl medical cost, which could include loss of wages during recovery from their injury. Initial C" S 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 nderstand that any violation of the terms of the owner/builder exemption shall be reported by the Building and o € oning Dep tment to the Florida Stat Department of Professional Regulation. Signed and acknowledged on this L day of of 207 . � p �� r t — w Z Owner/Builder Signature STATE OF FLORID ` k COUNTY OF �:.LC / oi., �,. The f regoing insh en acknowledged before me this day of 20��, by r7 who is personally known to me, or who has pr uced as identification. ignature of ary Ty or Print Name of Nota (Seal) Title: Notary blic Commission Number SLCPDSD Revised 07/22/2010