HomeMy WebLinkAboutSUBMITTED PAPERSV.
Date: 11 Fee Due: j..43o Receipt# a�OS _ �,�`Permit # 1 0 S' Z%;
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 0 Siding
See page 2 for instructions and additional paperwork required for specialty permits
1. Location/Site Address: %o n can ',jk Fo,rk- V%ertA Nt- 3yg5\
2. Parcel ID Number: i'tb\-- (u0'b 00'S(i- OCSO-
office Use
Only
Section
Township
Range
Map Page
Zoning
Land Use
Initials
3. Complete Description of Project or Work:
4. Owners Information 5. Contractors Information
Name: \11C)a4 , a M%ems 7stbbw-e-9- FL R� 1 t
Address: 1�k�LQ
County Cert#:
City:
State;
Business Name:
Zip: "Fl(,g S t Phon 2: 'SL Phone:
6. Value of ConstructionA Y z 10
OWNER'S AFFIDAwr: I certify that all of the information contained
compliance with all applicable laws regulati
PRINT OWNER OR CONTRACTOR NA `ME_ CL(5✓) -eSIGN,
STATE OF FLORIDA, COUNTY OF �����(
ACKNOWLEDGED BEFORE METHIS a \", DAY O
ion is correct
and zoning.
OF OWNER OR CONTRACTOR
20 13 . BYy 'N a'R l Jt, -Sg6,,,, SL tr
WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED
`�oyaYPOB?,,- HANNA GIVENS
AS IDENTIFICATION. �o ; Notary Public -State of Florida
� k-*"A fnq G. MY CRM Expires Dec 16, 2016
SiGNATUREOFNOTARY TYPE OR PRINT NAME OF NOTARY%;�oFco;�,` Commission # EE 858761
Bonded Through National Notary Assn.
COMMISSION NUMBERVIA ��� .
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 WrM 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 workers'
compensation for that employee, all as prescribed by law. Your construction must comply with all applic le la s I Q
ordinances, building codes, and zoning regulations. Initia J
I understand that the building official and inspectors are not there to design or give advice on ho to m et
the minimum code. Initia
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.
:I
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 li ble for h
cost of the license.L.-''� Initi�
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 medi
cost, which could include loss of wages during recovery from their injury.
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 ownerlbuilder exemption shall be reported by the Building and
Z009 Department to the Florida State Department of Professional Regulation. Signed and acknowledged on this
9N day of of 20y b .
1*11�
Own�r Builder'• atur
STATE OF FLORIDA
COUNTY OF 5k. %.v c.k
The oregoing instrument was acknowledged before me this QAday of Vsg.`I , 20 3 ,
by I \ C'k,\-L. 10,0.v"nt t' who is personally known I to me, or who has
produced LLD U aE ea -41 a. 1 - n 1 as identification.
Q g hn*, G Q, e's DEANNA GIVENS
Signature of Nolrary Type or Print Name of Not 2o`y s Not
fjnblic -State of Florida
Title: Notary Public Commission Number �� 5�i : •, My Comm. Expires Dec 16, 2016
;sqr P �c Commission # EE 858761
%O ; ��° Bonded Through National Notary Assn.
SLCPDSD Revised 07/22/2010
Property Appraiser - St.Lucie County, FL
Page 1 of 1
Vickie L Jasmer Record: 1 of 1
Property Identification
Site Address:
8006 Banyan St
Seclfown/Range:
14:34S :39E
Map ID:
13/14N
Zoning:
RS-4
Ownership and Mailing
Owner:
Vickie L Jasmer Joseph P Jasmer
Address:
8006 Banyan St
Fort Pierce FL 34951-2137
Sales Information
Date Price
Code Deed
8/6/2012
87000 0001 WD
3/1/1977
2600 01 CV
PROPERTY
RECORD CARD
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Exemptions Permits Home Print
Ly�CIE CO
ParcellD:
1301-603-0088.000-8
QrG�Ji�
Account 0:
705
co �
Use Type:
City/Cnty:
SF Res
St Lucie County
'
Legal Description
LAKEWOOD PARK -UNIT 3- BLK 20 LOTt (MAP 13/14N) (OR 3418-2924)
Assessment 2012
Book/Page 2012 Final: 60700
3418/2924 Assessed: 60700
0265 / 0939 Ag.Credit: 0
Exempt:
Taxable:
Taxes: 1228.03
BUILDING INFORMATION
Total Land and Building
Land Value: 6200 Acres:0.31
Building Value: 54500
Finished Area: 1532 SgFt
Exterior Features
View:
RoofCover:
SD - Dim Shingle
RoofStruct:
GA - Gable
ExtType:
HC- - HC-
YearBlt:
1977
Frame:
Grade:
C- - C-
EffYrBit:
1977
PrimeWall:
BS - CB Stucco
StoryHght:
0010-1Story
No.Units:
1
SecWall:
Interior Features
BedRooms:
3
Electric:
MX- MAXIMUM
PrmintWall:
DW - Drywall
FullBath:
2
HeatType:
FHA - FrcdHolAlf
AvgHt/FI:
1/26ath:
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 Oty.
Units Qua]. Cond.
YrBlt. No. Use Type
Type
Measure Depth
DWC - Driv-Concret
Y 1
720 AV AV
1977 1 0100-SF Res
BI -Front Ft
104.09 130
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?prelid=130160300880008 5/21/2013
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FALLS IN
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SURVEY' NOTES
CONCRETE DRIVE CROSSES PROPERTY LINE
ON SOUTHERLY SIDE OF LOT.
THERE ARE FENCES NEAR THE BOUNDARY
OF THE PROPERTY.
PROPERTY SUPPLIED BY CITY WATER AND
SEWER.
LOT 30
BLOCK 20
1 03.75' ANCHOR
�. • C6 I 10' U.E. & D.E.
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LB# 7893
FOUND 3/4"
ASS
IRON' PIPE
A'
0.8•4 S.
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SET 1 /2" 84.01'
IRON ROD
LB# 7893
LOT 29
BLOCK 20
FOUND 3/4"
IRON PIPE
P.P. I
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23.0'
BANYAN STREET
P.. 55.23 %Q' R—N/-.IMPROVED -_
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LOT 2
BLOCK 20
1Q. '
FOUND 3/4" 240.00'
IRON PIPE
0.6' W.
E.O.P.
PAGE 2 OF 2 PAGES
° H C
FIc N BOUNDARY SURVEY
•� S1 e
Vy 1.9. 4 1-
No.28S3
9 w SURVEYORS CERTIFICATE
x W
a I HERESYCERTIFY THAT THIS BOUNDARYSURVEY
IS A TRUE AND CORRECT REPRESENTATION OFA
s Z SURVEY PREPARED UNDER MY DIRECTION.
STATE OF NOT VALID WITHOUT AN AUTHENTICATED ELECTRONIC
�Hq L DRID., pa V SIGNATURE AND AUTHENTICATED ELECTRONIC SEAL,
s u R Nr c OR A RAISED EMBOSSED SEAL AND SIGNATURE.
ClydecNellysigned by Clyde
� McNeal
jr','DN: CN = Clyde McNeal, C =
'IJS, O = Target Surveying, Inc.
McNeal ~04' 02�b12.08;0216:23:19-
SIGNED ri
CLYDE 0. MCNEAL, PROFESSIONAL SURVEYORAND MAPPER #2883
20' ASPHALT ROAD
LB #7893
FOUND 3/4"
IRON PIPE
S.E.
CORNER
LOT 4
BLOCK 20
25.5' PARKWAY
TARGET
SERVING'ALL FLORIDA COUNTIES
FIL.E COPY
6250 N. MILITARY TRAIL, SUITE 102
WEST PALM BEACH, FL 33407
PHONE (561)640-4800
FACSIMILE (561)640-0576
STATEWIDE PHONE (800) 226-4807
STATEWIDE FACSIMILE (800) 741-0576