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HomeMy WebLinkAboutSUBMITTED PAPERSDate:(j)' .Fee Due: Permit # Planning & Development Services ..r.:i Building & Code. Regulations Division SCq.y - - - - - - - - -- - -2300-Virginia-Ave. g • ' _ - - ---__- _._ ___."z _ _ Fort rce, FL34982_ - Pie(a72)4624553 -SPECIALTY .PERM'I'_.A-.PLICATION ,. -- - O electrical O^I'lumbin - g o HVAC mce C e �-Demolition--SidIng- _ _- --_------- - - See page 2 for instructions and additional paperwork required for specialty permits - ------1.-Location/Site-Address:---- -- -- -- C a `'��- - - -------- - - -- ----- __--- 2. Parcel 16-Number: Office Use Only Section . Township Range Map Page ing Land Use Initials " 3. Complete Description of Project or Work: �7t`�"� . -d n (� e - r-1 -h '. /31 J1-4 - - • ul,& - - -f _ V_- *4- r--A Lo A jr,.— . n X trn X - _'R — W--oO tn, T fiU 'E k Gc I-.d ►'�. . Rati � .s • o l= 5� .4. Owners Information 5. Contractors Information - Name:. 24 r"q k 1, 3 Lk M a(\ FL Reg/Cert #: Address: SE .fie n oc-`ti C 0 Vt,+ County Cert#: City: - 5-�-. (�jGt-Q_ - --- State:--- : ----- Business -Name: Zip: 01 Phone: Phone: Fa 6. Value of.Construction: $ 3au 4b ' 35-0. o0 OWNER'S AFFIDAVIT: I certify that all of the, information contained in this application is correct and that all work will be done in with all -applicable laws regulating construction and zoning. �.,compliance J `^. SIG OP115WAROR CTOR PRINT OWNER ORCONTRACTORNAME STATE OFT LORIDA COUNTY -OF ST ACKNOWLEDGED BEFORE ME THIS DAY O - -- - -20 13 BY - - - __WHO_IS:PERSONALLY_KNOWN_TO_ME.._ .OR-WHOHASPRODUCEI) L. A ENTIFICATION." 4k -ANGELA M. HUFF " 12,2015 Pulblic BoK&Mru Notary nderwrltet SIGNATURE OF N ARY TJOE OR PF4n NAME 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 wrm CONTRACT UNDER $7500.00 . Revised 04/26/2010 kj1 Planning & Development Services Department Building & Code Regulations © " e 2300 Virginia Avenue Fort Pierce, Florida 34982 ,w(772) 462-1553 _ OWNERBUILDER AFFIDAVIT DISCLOSURE STATEMENT_ ---- --- ------ --- - -- - - --- —_ F.S._489.103-(7)-EXEMP-TIONS-- --- _--- --- State law requires construction'to be done-by_hcerised contractors You have applied for apermider 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 impr---oved-for-sale-or-lease.--If-you-sell=or-lease-a-building-you-have-built-or-substantially-improved-yourself-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 riot licensed -to perform the wdrk­bemgTdone. 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 a e laws, ordinances, building codes, and zoning regulations._ Inift I understand that the building official and inspectors are not there to design or give advice on o meet the minimum code. Initial d1S 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 requir d to be licensed in this jurisdiction. If for some reason they do not possess a license, I may be responsible.and li r .the cost of the license. Initial I understand that if any person that is unlicensed and uninsured gets injured on my construction pro'ect- they may be entitled to workmen's compensation. I could be held liable for all doctor, lawyer and relate 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 Regulation. Signed and acknowledged on this _ {— day of of 20 L --*k . / . er/Builder Signatur STATE OF FLORIDA COUNTY OF The foregoing instripent was acknowledged before me this L day of by ` C �('�.� wh -is ersonally known to me, or who has produce YV— _ ["IZ n I I T7 G, as identification. Signature ofN ary ` e Type or Print N ofNotary ' .,. "I I", GELA M. HUFF. Title: Notary Public Commission N er ;.r r MY COMMISSION # EE 083530 s� oz EXPIRES: Apol 12, 2015 pf W Ecsded 7hru Notary Public Underwriters SLCPDSD Revised 07/22/2010-- S rroperry Appraiser - bLixcie uoumy, r1, mtp://www.pasic.orgfpasic/prc.asp-(prcua=s4 9:)4UU14000U / r PROPERTY RECORD CARD MizraimJuman Record:l of 1 <<Prev Next » Spec.Assmnt Taxes Exemptions Permits Home Print Property Identification CIE � Site Address: 184 SE SERENATACT ParcellD: 3419-540-0140-000-7 Sec/Town/Range: 28 :36S :40E Account #: 42817 Map ID: 34128N Use Type: SF Res Zoning: R84 City/Cnty: St Lucie County Ownership and Mailing Owner: Mizraim Juman Cynthia Juman Address: 590 NW 194th St Miami Gardens FL 33169 Sales Information Date Price Code 11/14/2011 40000 0001 1/10/2007 138000 00 1/1/1900 0 Legal Description RIVER PARK -UNIT 5 BLK 47 LOT 3 (MAP 34/28N) (OR 3340-2816) Assessment 2012 Deed Book/Page 2012 Final: 29400 WD 3340/2816 Assessed: 29400 WD 2749 / 2290 Ag.Credit: 0 / Exempt: Taxable: Taxes: 594.8 BUILDING INFORMATION 2 o crwal 1! I] Total Land and Building Land Value: 6800 Acres: 0.24 Building Value: 22600 Finished Area: 1144 SgFt Exterior Features View: - RoofCover: RC - Roll Comp RoofStruct: GA- Gable ExtType: HC - HC YearBit: 1959 Frame: - Grade: C - C EffYrBit: 1959 PrimeWall: BS - CB Stucco Storylight: 0010-1 Story No.Units: 1 SecWali: - Interior Features BedRooms: 3 Electric: MX- MAXIMUM PrmintWaii: DW - Drywall FullBath: 1 HeatType: - AvgHt/Fl: 1/26ath: 0 HeatFuel: - Prm.Flors: TZ-Terrazo %A/C: 0 %Heated: 0 WSprinkfed: 0 Special Features and Yard Items Land Information Type Y/S Qty. Units Qua]. Cond. YrBlt. No. Use Type Type, Measure Depth SDSF- SITEDEVS-F Y 1 1 AV AV 2001 1 0100SFRes 260-Front Ft 76.5 137 THIS INFORMATION IS BELIEVED TO BE CORRECT AT THIS TIME BUT IT IS SUBJECT TO CHANGE AND IS NOT WARRANTED. 1 of 1 6/4/2013 11:30 AM