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Home My WebLink AboutSUBMITTED PAPERSDate: Fee Due: ,6 0- 1 Receipt# �\T I Permit # Afi , n t Planning & Development Services Building & Code Regulations Division 2300 Virginia Ave. Fort Pierce, FL 34982 (772)462-1553 SPECIALTY PERMIT APPLICATION ❑ Electrical ❑ Plumbing ❑ HVAC Fence ❑ Shed ❑ Demolition ❑ Gas ❑ Siding Seepage 2 forinstructions and additional paperwork required for specialty permits 1. Location/Site Address: _ 9 � o , �'e o V � /IpQQJ 2. Parcel ID Number: Office Use Only Section Township Range Map Page Zoning Land Use Initials ) 3. Complete Description of Project or Work: 4. Owners Information U 5. Contractors Information Name: G1 Cz ,rYYi�n Address: (gl u, ke n w=d, Y(1 City:-�,-P �� State: ^� Zip: �"1�IJ Phone: Sag- 0(00!5 6. Value of Construction: $ -As OWNER'S AFFIDAVIT: I certify that all of the information contE compliance with all applicable laws, rep_'�� rl n� PRINT OWNER OR CONTRA* O� CTOR NAME I \ /) r i STATE OF FLORIDA, COUNTY OF ACKNOWLEDGED BEFORE ME THIS / L2 DAY OF WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCI AS IDENTIFICATION. SIGNA COMMISSION NUMBER m FL Reg/Cert #: County Cert#: Business Name: Phone: Fax: "is application is corr t and that all work will be done in g• . struction an zon' __-- URE OF OWNER OR CONTRACTOR Y 15I 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 AUDREY B. wim?"REY Revised 04/26/2010 ;r, rAy °Y MY COMPAISSION. EE p61159 a1+- atctr b, 2015 *: = EXPIRES: M Under* �a ..,•..o? gonded?hru NOWY Public Under 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 'ca et , ordinances, building codes, and zoning regulations. Initial_ I understand that the building official and inspectors are not there to design or give advice on o ts� ee, the minimum code. Initial 1: I understand that as an owner -builder that any contract disputes with sub -contractors and I must be handed in a civil court with the advice of an attorney. This department will not mitigate any contract disputes. Initial C� 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 Ikablerfo tfi cost of the license. Initial - I understand that if any person that is unlicensed and uninsured gets injured on my construction proje9t they may be entitled to workmen's compensation. I could be held liable for. all doctor, lawyer and relat me calf cost, which could include loss of wages during recovery from their injury. Initial f , 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 7,S— Department to the Florida State Department of Professional Regulation-ed_and ac o ledged- on this g Tday of of 20 wnerBuilder Signature STATE OF FLORIDA COUNTY OF The foregoing ' ument was acknowI dged before me this �d day o 1 • 2V , by t �� who is personally known to me, or who has produced d1__J K:>• ", C,1 as identification. h't, A- iy:�� & 12) (5--il S ature of of T or Print Name of otary (Seal) Title: Notary Pu is Commission Number SLCPDSD Revised 07/22/2010 �UMPHRV pUDREY B H .061, WIG 59 COMMISSION I *: EVIREcig,? kcUndef+l s 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 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 U- ence fence Attach 2 plot plans showing location of fence height of fence and type of ❑ 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 Owl FL 0 Page 1 of 1 PROPERTY RECORD CARD Licia M Peterman Record: 1 of 1 <<Prev Next» Spec.Assmnt Taxes Exemptions Permits Home Print Property Identification Site Address: 8106 KENWOOD RD ParcellD: 1301-605-0335-000-1 Sec/Town/Range: 02 :34S :39E Account*: 1357 ¢ �? Map ID: 13/02S Use Type: SF Res Zoning: RS-4 City/Cnty: Saint Lucie County Ownership and Mailing Legal Description Owner: Licia M Peterman LAKEWOOD PARK -UNIT 5- BLK 54 LOT13 (MAP 13/02S) (OR 1954- Address: 8106 Kenwood Rd 238; 3585-2333) Fort Pierce FL 34951-1300 Sales Information Assessment 2013 Total Land and Building Date Price Code Deed Book/Page 2013 Final: 81800 Land Value: 4800 Acres: 0.24 10/1/2013 0 0111 FJ 3585 / 2333 Assessed: 81800 Building Value: 77000 4/20/2004 143400 00 WD 1954 / 0238 Ag.Credit: 0 Finished Area: 1655 SgFt 8/8/2003 11000 00 WD 1779 / 2253 Exempt: 50000 9/11/2002 3500 00 WD 1585 / 2317 Taxable: 31800 1/1/1900 0 / Taxes: 825.46 111111l1121e71.1�1:1i�if Y>rL�lil f, f eniR h im) Exterior Features View: RoofCover: FS - Fibrglss Shg RoofStruct: HP - Hip ExtType: HC+ - HC+ YearBlt: 2004 Frame: - Grade: C+ - C+ EffYrBlt: 2004 PrimeWall: BS - CB Stucco StoryHght: 0010 -1 Story No.Units: 1 SecWall: - Interior Features BedRooms: 3 Electric: MX - MAXIMUM PrmintWall: DW - Drywall FullBath: 2 HeatType: FHA - FrcdHotAir AvgHt/FI: 1/213ath: 0 HeatFuel: ELEC - Electric Prm.Flors: CU - Carpet %A/C: 100 %Heated: 100 %Sprinkled: 0 Special Features and Yard Items Land Information Type Y/S Qty. Units Qual. Cond. YrBlt. No. Use Type Type Measure DWC - Driv-Concret Y 1 765 AV AV 2003 1 0100-SF Res BI -Front Ft 80 THIS INFORMATION IS BELIEVED TO BE CORRECT AT THIS TIME BUT IT IS SUBJECT TO CHANGE AND IS NOT WARRANTED, Depth 131 http://www.paslc.org/pasle/pre.asp?prclid=130160503350001 2/10/2014 Wd Z4: W 17402: 106 qaA 'AepuoW qp • Monday, Feb 10, 2014 01:42 PM 0 W SloL Kenwc� �l 4+ Rye F'ILE. COPY 7,e/rm I+ 1,4 oa 01 I C*,s �- Applicant has been advised 110 structures can be erected within any or right of way unless 'se proved. Applicant Initials So,-�r)