Loading...
HomeMy WebLinkAboutSUBMITTED PAPERSPlanning & Development Services Building & Code Regulations Division 2300 Virginia Ave. Fort Pierce, FL 34982 5? (772)462-1553 SPECIALTY PERMIT APPLICATION .21 Electrical ❑ Plumbing ❑ HVAC ❑ Fence ❑ Shed ❑ Demolition ❑ Gas ❑ Siding Seepage 2 for instructions and additional paperwork required for specialty permits �C'�iV.vz �c 1. Location/Site Address: 3505 E� 3 `i 9 47-1 2. Parcel ID Number: ©� - — 0 00 4 " 00 D (1 Office Use Only Section Township Range Map Page Zoning Land Use Ini 'als 3. Complete Description of Project or Work: p e ltc-- --(2- i✓4 4. Owners Information 5. Contractors Information Name: FL Reg/Cert #: Address: 6 L- 62 V\W to-\ A \O - County Cert#: City: d ram_ State: Business Name: Zip: 3 3 Phone: 3 o S _ $ lS-d `C(1p Phone: Fax: 6. Value of Construction: $ �.30c:� 1' � \1 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 construction and zoning. PRINT OWNER OR CONTRACTOR NAME �OF OW NER WNER OR CONTRACTOR STATE OF FLORIDA, COUNTY OF ACKNOWLEDGED BEFORE ME THIS DAY OF 20 BYQWA� E—�W WHO IS PERSONALLY KNOWN TOME OR WHO HAS PRODUCED r,b�NTIFICATION. ^ SIG AMN ARY TYPE C COMMISSIOER 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 NOTICE TO OWNER: FA`-_:E TO RECORD A NOTICE OF COMMENCEML _YSAY 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 ❑ 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 4:3.0 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. 5 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 Building & Code Regulations Division 2300 Virginia Ave Fort Pierce, FL 34982 772-462-1553 Owner Builder Affidavit — Electrical Contracting DISCLOSURE STATEMENT F.S. 489.503 (6) EXEMPTIONS State law requires electrical contracting to be done by licensed electrical 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 electrical contractor even though you do not have a license. You may install electrical wiring for a farm outbuilding or a single-family or duplex residence. You may install electrical wiring in a commercial building the aggregate construction costs of which are under $75,000. The home or building must be for your own use and occupancy. It may not be built for sale or lease. If you sell or lease more than one building you have wired yourselfwithin 1 year after the construction is complete, the law will presume that you built it for sale or lease, which is a violation ofthis exemption. You may not hire an unlicensed person as your electrical contractor. Your construction shall be done according to building codes and zoning regulations. 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. Failure to do so may result in a liability for you! To qualify for this exemption under this subsection, an owner must personally appear and sign the building permit application. 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 Community Development Director to the Florida State Department of Professional Regulation. Signed and acknowledged on this _ day of i 2-v u c. KL , 2014 STATE OF FLORIDA COUNTY OF, L The foregoing instrument was acknowledged before me this day of , 20 L ,1 by�-C ., who is personally known tome or Signature of Title: Notary Public Print name o0otary Commission Number ANGELA M. HUFF MY COMMISSION # EE 083530 EXPMES: April 12, 2015 Bonded Thru Notary Public Underwriters SLCPDSD Revised 7/23/2010 6"j�_ ✓\ ���-� J Y`�V,✓� St. Lucie County Owner Builder Affidavit -Electrical Contracting