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Home My WebLink AboutSUBMITTED PAPERSDate: Receipt#: Permit #: Initials—f Q, �131 �yYq PLANNING AND DEVELOPMENT SERVICES DEPARTMENT Building and Code Regulations Division 2300 Virginia Ave. C� IF L ` Fort Pierce, FL'34952 ;NAI&L (772)462-1553 St UC B C SPECIALTY PERMIT APPLICATION °Unty ❑ Electrical ❑ Plumbing ❑ HVAC Fence ❑ Commercial Irrigation ❑ Shed ❑ Demolition ❑ Gas ❑ Siding See page 2 for instructions and additional paperwork required for specialty permits 1. Location/Site Address: \Z ��` 9 \ �\ 2. Parcel ID Number: 3. Complete Description of Proposed Work: CA 4. Owners Information 5. Contractors Information Name: FL Reg/Cert #: Address 2�, ounty Cert#: City:State: Business Name: Zip: Phone: 6. Value of Construction: $ Email: 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 con7/77T/ g. PRINT OWNER OR CONTRACTOR NAME �^ SIGNATURE OF OWNER OR CO STATE OF FLORIDA, COUNTY OF ACKNOWLEDGED BEFORE ME THIS DA 20,u 1 , BY d�Cd� \ �' A }� h-. d J A! WHO IS PERSONALLY KNOWN TO. ME R WHO HAS PRODUCED AS IDENTIFICATION. , o, DEANNA GIVENS °r .�. �: Notary Public -State of Florida M Comm: Ex it$ c 16, 2016 SIGNATURE OF NO Y TYPE OR PRINT NAMEOFNOTAR°� my E�858761 �t ,"''%°�� „P Bonded Through National Notary Assn. COMMISSION NUMBER � _'LA5$ `(D ` 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 01/03/2014 11\J ■ 1lV 1.1 IV1YJ Please complete all inform.n*-^n in;the space provided. All informaf, . 4,must be printed (use., black or blue ink only) or typed. This permit,_ ..,;)licatiori is to be used only for those i, ^ities 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 activityistaking 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. 0 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 0 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 musfbe 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 he 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. Shed/Location Permit PLEASE LOCATE SHED AND ALL BUILDINGS WITH SETBACKS TO THE PROPERTY LINES. Example of Plot Plan for shed. Please show distance from shed to the lot lines Smith Lane FRONT PROPERTY LINE ON ROAD All applications for Shed - Locational Permits are to be submitted to the St. Lucie County Building and Zoning Department, St. Lucie County Administration Building, 2300 Virginia Avenue, Fort Pierce, FL 34982. All applications for Shed - Locational Permits must be complete and filed with the Department no later 4:30 P.M. each business day. No applications will be accepted for processing after 4:30 P.M. For assistance in completing this application, please contact the St. Lucie County Building and Zoning Department, at (772) 462-1553, during regular office hours (8:00 AM - 5:00 PM), Monday through Friday. Following the issuance of this Shed - Locational Permit, the scheduling of all required inspections may be made by calling (772) 462-1261. SLCPDSD 4/11/2011 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 hot 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 applica 1 ws, ordinances, building codes, and zoning regulations. Initial I I understand that the building official and inspectors are not there to design or give advice on ho b eet the minimum code. Initial I understand that as an owner -builder that any contract disputes with sub -contractors and I must be h led 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 liab r the cost of the license. Initial I understand that if any person that is unlicensed and uninsured gets injured on my construction proj' ct- they may be entitled to workmen's compensation. I could be held liable for all doctor, lawyer and relate ical 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 owner/builder exemption shall be reported by the Building and Zoning_Department to the Florida State Department of Professional Regulattioo S40dd, d :cr�Zedg on this of ' � - of 20 j�.///,, yf V OWnt Builder Signdfure STATE OF FLORIDA COUNTY OF :SA-, L-0 r %-k, The foregoing instrument was acknowlg�ged before me this �� 'day of �_00 , 20�, by 1J z T'\ Ar'% `l 0*0 VS, who is personally known to me, or who has produced W. �0'S 5 - 3 �o - �i as identification. Q �► n � G-� v �.,nr g Signature of Not Type or Print Name of Notary , ( GIVENS Title: Notary Public Commission Number ET-Q 6�� fpa�- DEANNA State of Florida SLCPDSD Revised 07/22/2010 :faY POA<;'� Notary Public - 2016 My Comm. Expires Dec 16, • Commission # SE 858761 • Assn. J ♦ .. , Bonded Through National No ar GE Security EST Fire & Life Safety Date V-LE COPY -C Project: Description: J T- (A A J I T- Appicanthas can be erected been advised within any NOstr .4: nt �ctures or t AppIligant ow 0 InItIaW—i proved. - -_ -� '' I I--f --� I —_� -tl � I - _ I ___ -__� ( I LI—__� I I 1 f I � T_--I� III II it �,I ,!r , I�I� _ J ! -- -- '- - i-�---;--I ---! � � it i ��;-- i j-------- —I — � ----�y-�`=- EST�_ www.gesecurity.com/est Property Appraiser - St.Lucie County, FL Page 1 of 1 Natalie R Martin Record: 1 of 1 Property Identification Site Address: 1009 GOPHER RIDGE RD Sec/Town/Range: 09 :36S :40E Map ID: 34/09N Zoning: RS-3 Ownership and Mailing Owner: Natalie R Martin Address: 1009 Gopher Ridge Rd Fort Pierce FL 34982-3320 Sales Information Date Price Code 2/24/2005 100 01 7/26/2002 56000 00 7/1/1984 28000 00 12/1/1973 21800 00 PROPERTY RECORD CARD <<Prev Next» Spec.Assmnt Taxes Exemptions Permits Home Print ParcellD: 3409-501-0028-000-4 s ��& �pG2 Account #: 40193 Use Type: SF Res { City/Cnty: Saint Lucie County ' Legal Description ORANGE GROVE PARK LOTS 28 AND 29 (0.36 AC) (OR 1560-2997: 2175-188) Assessment 2013 Deed Book/Page 2013 Final: 29200 QC 2175/0188 Assessed: 29200 WD 1560 / 2997 Ag.Credit: 0 CV 0439 / 1045 Exempt: 25000 CV 0222 / 1016 Taxable: 4200 Taxes: 85.05 BUILDING INFORMATION Total Land and Building Land Value: 14500 Acres: 0.36 Building Value: 14700 Finished Area: 778 SgFt e Exterior Features View: - RoofCover: SA - Asph Shingle RoofStruct: GA - Gable ExtType: HD+ - HD+ YearBlt: 1951 Frame: Grade: D+ - D+ EffYrBlt: 1960 PrimeWall: WN - Wood no Sh StoryHght: 0010 -1 Story No.Units: 1 SecWall: Interior Features BedRooms: 2 Electric: AV - AVERAGE PrmintWall: PN - PN FullBath: 1 HeatType: AvgHt/FI: STD 1/2Bath: 0 HeatFuel: Prm.Flors: DP - Double Pine %A/C: 0 %Heated: 0 %Sprinkled: 0 Special Features and Yard Items Land Information Type Y/S Qty. Units Qua]. Cond. YrBlt. No. Use Type Type Measure Depth SDSF - SITE DEV S-F Y 1 1 AV AV 2001 1 0100-SF Res 230 -Front Ft 108 147 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=340950100280004 2/13/2014