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Home My WebLink AboutSUBMITTED PAPERS,? 7 14 Date: Fee Due. Permit # - C ❑ Electrical ❑ Shed Planning & Development Services Building & Code Regulations Division 2300 Virginia Ave. Fort Pierce, FL 34982 (772)462-1553 SPECIALTY PERMIT APPLICATION ❑ Plumbing ❑ HVAC ffFence ❑ Demolition ❑ Gas ❑ Siding Seepage 2 for instructions and additional paperwork required for specialty permits 1. Location/Site Addri 2. Parcel ID Number: 3. SCq st "Cie Gig �oUnty Township Range Map Page Zoning Land Use Initials Office Use Section Only 4. Owners Information 5. Contractors Information Name: FL Reg/Cert #: Address: County Cert#: City: State: Business Name: Zip: 005 �, Phone:—A,a slip Phone: Fax: gol0 n 6. Value of Construction: $ OWNER'S AFFIDAVIT: I certify that all of the information contained in this application is correct and that all work will be done m compliance with all applicable laws regu�g construction and zoning. /. PRINT OWNEP 01 CONTFTORWAMENj SIGNATURE OF jrR O O STATE OF FLORIDA, COUNTY OF �') /�/ I ACKNOWLEDGED BEFORE ME THIS DAY OF / " n a l/`-t " /)20.�4_ BY rC)1?7/97 y IW /� V WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED , r rn AS I NTIFICATION. / , / 4, � V /- 1�c � �� m pig ��seal) S NATURE O OTARY �R PRINT AME OF NOTARY AME 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 ° AUDREI! B. itUMPiiREY MY COMMISSION # EE 061159 •" 2015 EXPIRES: March 6, T? ftQ; Bonded Thru Ndary Public Underwriters NOTICE TO OWNER: FAILURE PECORD A NOTICE OF COMMENCEMENT M- .:ESULT 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. Planning & Development Services Department i Building & Code Regulations s • 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 appli 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 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 e 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 ownerlbuilder exemption shall be reported by the Building and Zonipg Department to the Florida State Department of Professional Regulation. Signed and acknowledged on this �_ ay of of 20 jq . Owner/BIdSignatur STATE OF FLORIDA COUNTY OF The for oing instrumen was acknowled ed efore me this � day of 20 by who is personally known to me, or who has Drodu�ce �� _ i 'l' - as identification. ignature of tary Type or Print Name of Nota y (Seal) Title: Notary Public Commission Number SLCPDSD Revised 07/22/2010 _ AUDREY B. HUMPHREY MY COMMISSION # EE 061159 r EXPIRES: March 6, 2015 Bonded Thru Notary Public Underwriters Property Appraiser - St.Lucie r-•-nty, FL Page 1 of 1 PROPERTY RECORD CARD Victoria W Potter Record: 1 of 1 «Prev Next» Spec.Assmnt Taxes Exemptions Permits Home Print Property Identification c0�y� Site Address: 270 Berger Rd ParceliD: ��CIE Sec/Town/Range: 09 :35S :39E Account #: 13340 Map ID: 23/09N Use Type: Vac Res Zoning: AG-1 City/Cnty: Saint Lucie County4iuk Ownership and Mailing Legal Description Owner: Victoria W Potter Tammy W Murphy R G ALLEN S/D-AN UNRECORDED PLAT IN SEC 9-35-39 BLK 2 Address: 1003 Ibis Ave LOTS 10 AND 11 (0.60 AC) (OR 2413-485: 2429-27 Fort Pierce FL 34982-8316 More... Sales Information Assessment 2013 Total Land and Building Date Price Code Deed Book/Page 2013 Final: 20200 Land Value: 20200 Acres: 0.6 5/3/2012 100 0311 TR 3391 / 2910 Assessed: 20200 Building Value: 0 6/20/2006 100 02 QC 2609 / 1474 Ag.Credit: 0 Finished Area: 0 SgFt 6/20/2006 100 02 TR 2594 / 2441 Exempt: 12/7/2005 100 02 QC 2434 / 2631 Taxable: 11 /8/2005 100 02 QC 2413 / 0485 Taxes: 409.09 9/29/1994 3600 01 DE 1008 / 2758 10/1/1987 10000 00 CV 0563 / 2049 4/1/1978 4000 00 CV 0286 / 2499 BUILDING INFORMATION No Sketch No Image Available Available Exterior Features View: - RoofCover: RoofStruct: ExtType: - YearBit: Frame: Grade: - EffYrBit: PrimeWall: StoryHght: - No.Units: SecWall: Interior Features BedRooms: Electric: PrmintWall: FullBath: HeatType: AvgHUFI: 1/213ath: HeatFuel: Prm.Flors: %A/C: %Heated: %Sprinkled: Special Features and Yard Items Land Information Type Y/S Qty, Units Qual. Cond. YrBlt. No. Use Type Type Measure Depth 1 0000-Vac Res 220 -Front Ft 200 129 THIS INFORMATION IS BELIEVED TO BE CORRECT AT THIS TIME BUT IT IS SUBJECT TO CHANGE AND IS NOT WARRANTED. AS - O-Z? �, q , Q5 http://www.paslc.org/paslc/prc.asp?prclid=230950100220002 3/7/2014 R 1 _\ V-6,ve. -k c2c �— 1�)e)/ J+�