The URL can be used to link to this page

Home My WebLink AboutSUBMITTED PAPERSDate: � jk k a e Due: J Receipt# 7 1"Te- rmit # Planning & Development Services Building & Code Regulations Division SCIANNE/`' 2300 Virginia Ave. J B y Fort (�erce, FL 3 982 t UCie Coupi / 1 SPECIALTY PERMIT APPLICATION ❑ Electrical ❑ Plumbing ❑ HVAC Fence ❑ Shed ❑ Demolition ❑ Gas Siding Seepage 2 for instructions and additional paperwork required for specialty permits 1. Location/Site Address: �� rJ� iv/ �L v tJ' 1'y t e b-ce- L i 2. Parcel ID Number: i- ( rz�s- - Township Range Map Page ning Lan se Initials Office Use Section Only 3. Complete Description ?411a✓Ll' 44G1_J. 4. Owners Information 5. Contractors Information Name: �� h. � k" 1�� i'c Zf' ,!� FL Reg/Cert #: Address: 5 �(� ;%� ,>�j �1�'�� /p�� County Cert#: City: �� a id:✓ce State: Business Name: Zip: 61-1 Phone: Phone: 6. Value of Construction: $ OWNER'S AFFIDAVIT: I certify that all of the information contained in this application is co,,sr d that ` 11 work will be done in compliance with all applicable laws re S c ' n and z%ning. PRINT OWNER OR CONTRACTO AME n OWNER OR C OR STATE OF FLORIDA, COUNTY OF `G �,1 n ACKNOWLEDGED BEFORE ME THIS DAY OF C �J 20ABY WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED-� Ie-C) �J ' V ilbkNTIFICAUON. �- ANGEL... HUF. r. L o 4Y CIOfV B EE 083590 1 o kV\X op SIGNATURE O=NOY TYPE OR PRINT N F ff, EXPIRES: April 12, 2015ffti8on0e� Pubiic UntieCOMMISSION - rwriters 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 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 work s' compensation for that employee, all as prescribed by law. Your construction must comply with all applica ; ordinances, building codes, and zoning regulations. Initial —' I understand that the building official and inspectors are not there to design or give advice 0 .0- v t the minimum code. Initial 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. lJ Initial- 1 understand that if I compensate any person or company for work performed they are required to t e licensed in this jurisdiction. If for some reason they do not possess a license, I maybe responsible and liable or, 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 relate dical-•----._ 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 fiuther understand that any violation of the terms of the owner/builder exemption shall be reported by the Building and Zoning Dep ent Ito the Florida State Department of Professional Regulation. Signed and acknowledged on this i) q 1Z day of of 2. ` � �-'" . % � _ �) _ Owner iuilderSignature— STATE OF FLORIDA COUNTY OF l The e�going instrument was acknowl d before me this 1 �- day of \ 20�� by r\ who is personally known to me, or who has produced identification. 'IM S1gna� tart' Type or PrintName of Notary (Seal) Title: Notary P blic Commission gumber ,3 ,.O:AP'F4o1!•,: ANGELA NI. HU FF SLCPDSD Revised 07/22/2010 + *•' +„ » MY COMhkSSiON # EE 083530 %Q EXPIRES: April 12, 2015 F Bonded Thru Notary Public Unde w., m- LEGAL DESCRIPTIONt ALL OF LOT 17. BLOCK XX LAKEWOOD PARK. UNIT No_ 5 ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK TL PAGE 5 OF THE PUBLIC RECORDS OF ST. LUCIE CO_ FLORIDA SAID LANDS LYING IN ST. LUCIE GO.. FLORIDA. CONTAMMG 0.27 ACRES MORE OR LESS. FLOOD ZONEt X. PANEL NO. 12111CO070J CFRTIir?IED- TO•. - - SHERRON SWAPP QUICKEN LOANS. ISAOA 15LAND HOUSE TITLE. LLC WESTCOR LAND TITLE INSURANCE COMPANY FND REBAR- 0.2'N. 0.5V- FND CAPC?3 0.7'N. 0.2V. SURVEY NOTESt L LANDS SHOWN HEREON WERE NOT ABSTRACTED FOR RIGHTS -OF -WAY AND/OR EASEMENTS OF RECORD. 2. NORTH ARROW SHOWN HEREON 15 BASED ON RECORD PLAT. s 3. THIS SURVEY 15 CERTIFIED ONLY TO THE BELOW NAMED INDIVIDUALS. 4. ELEVATIONS CIF 5HOWN3 HEREON ARE BASED ON N.A.VJD. C19B83. UNLESS OTHERWISE NOTED. 5.-LEGAL DESCRIPTION SUPPLIED BY CLIENT. G. NO STRUCTURES OR UTILME5 THAT ARE BENEATH THE SURFACE HAVE BEEN LOCATED. pant has been advised NO struct� be erected wA R D E N PARKWAY within any easement ors' Of way unless se a' I nt Initlalspproved.0 �tT��-- 70R/W 3 v-1 LOT 14 I LOT 15 LEGEND OF SURVEY ABBREVIATIONS D&U E DRAINAGE & UTITLTY EASEMENT all ELEVATION CHAIND LINK FENCE ® DELTAASBUILFND FND A/C AIR CONDITIONER I.P. IRON PIPE WELL TO PROPERTY. G.3' BLK BLOCK I.R. IRON ROD WELL TO HOU5E. 55.8' B.M. BENCHMARK L LENGTH SEPTIC TO HOUSE B.B. BEARING BASE M MEASURED .5.G' WELL TO 5t:M- 81.5- C CALCULATED N&D NAIL & DISK LOT 1G R=20.00' L=15.75' A=45'07'00' CD=15.34' '-LOT__-.2-G - 4 UAtaEu xxIx U)tatn coo cqvfm a 1 Y 04 r/L��(.f I/— JOZ c/lIctill e; Pik (/J//4/OS4 S G t�Y U 1 SQ" -/- toed ee of A4 Z .INL� ovr o-o 4,Ao,-r n 4,s, -xe, eee. Ct Ci GL. i �I c' � .GZ ( C C ✓ � � V S � C1 &C G-e U e