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HomeMy WebLinkAboutSUBMITTED PAPERSr OFFICE USE ONLY: I Date: IBC 13 Fee Due: 54 O p Receipt# (j Permit # PLANNING & DEVELOPMENT SERVICES BUILDING. & CODE REGULATION DIVISION ISCA 2300 Virginia Avenue. NN D Ft, Pierce, FL 34982-5652 Q 772-462-1553 St, L(lC� Y . APPLICATION FOR ALUMINUM STRUCTURES PERMT ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED PROJECT INFORMA� TIO'5o LOCATION/SITE DRESS: �, � 2. PROJECT NAME: TE PLAN NAME: f4f_ / L 3. , PROPERTY TAX ID #: �, ' CF ®� V" ®606 I-L 4. LEGAL DES TION (attac extra sheets if necessary). ! ' o. n "" 5. PLAT BK PAGE BLOCK LOT l p 1 i �r✓E% lA.�f' ei u `� ` 4 6. PARCELSIZE: ACRES/SQ FT. LOT DIMENSIONS f 7. SETBACKS (ACTUAL) FRONT: 5,1 2 BACK: D RIGHT SIDE: LEFT SIDE: C. 1;� 8.. TYPE OF STRUCTURE (CHECK ALL APPROPRIATP, BOXES FOR EACH AND EVERY TYPE OF STRUCTURE) ® S rf—l'ab own ade SQUARE FEET OF TYPE OF CONSTRUCTION A = Addition SR = Raised Slab DIMENSIONS CONSTRUCTION R = Rebuild WD = Wood Deck SCREEN ROOM. NEW 4vx - CARPORT/PATIO ROOF ❑ NEW ❑ EXISTING X ❑ HABITABLE GLASS ROOM ❑ NEW ❑ EXISTING X ❑ CAT 1, 2 OR 3 SUNROOM ❑ NEW ❑ EXISTING X ❑ ALUMINUM COMP. SHED ❑ NEW ❑ EXISTING X ❑ POOL ENCLOSURE ❑ NEW ❑ EXISTING X ❑ M H ROOF OVER ❑ NEW ❑ EXISTING X ❑ ROOF SYSTEM OVER ❑ NEW 0 EXISTING X EXISTING ACCESSORY STRUCTURE ❑ OTHER: ❑ NEW ❑ EXISTING X ❑ ALUM POOL FENCE Linear feet TOTALSQUARE FOOTAGE OF CONSTRUCTION 9. VALUE OF CONSTRUCTION: $ The value of construction is used to determine the amount of permit fees to be assessed. 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 activities. If the value is $2500 or more, a RECORDED Notice of Commencement must be submitted PRIOR TO FIRST INSPECTION. SLCCDV Form No.: 001-02 M v.04126/i010 OWNER 1 FORMATIOON CC`- �� NAME: ADDRESS:o� S CITY: 4 STATE. a ZIP PHONE (DAYTIME): (4j l 1'���� EMAIL: N FILL IN NAME AND ADDRESS BELOW IF THE FEE SIMPLE TITLEHOLDER (PROPERTY OWNER) IS DIFFERENT FROM THE OWNER LISTED ABOVE: FEE SIMPLE TITLEHOLDER: ADDRESS: CITY: STATE: ZIP PHONE (DAYTIME): CONTRACTOR INFORMATION STATE OF FLORIDA REG./CERT #: ST. LUCIE COUNTY CERT #: BUSINESS NAME: QUALIFIER'S NAME: ADDRESS: CITY: STATE: ZIP PHONE (DAYTIME): (_) FF(A�X email: NO. Q ��l ARCHITECT/ENGINEER: ' Ce� b 11��"l ADDRESS: A? 0 41 Si W r �,9'7 o'er �7 � CITY: t✓41'ae- STATE: ZIP :5075-0 PHONE (DAYTIME): =% NOTE: H APPLICABLE, SUBCONTRACTOR AGREEMENTS MUST BE ATTACHED TO APPLICATION FOR ROOFING, ELECMC, PLUMBING, AND HVAC ZONING REQUIREMENTS All such structures will be subject to the requirements of the ST. LUCIE COUNTY LAND DEVELOPMENT CODE. ❑ 2 scaled plot plans showing lot size, dimensions of existing host structure, and proposed aluminum addition. All setbacks including front, side, rear and distance between adjacent property structures in MH Parks shall be indicated on the plot plan. ❑ '2 sets of color photos for all storm damaged areas to be reconstructed. One picture must include house address number for inspection verification. ( not required for construction unrelated to storms) ::.6Mdg. USE 0NLy SECTION TOWNSHIP RANGE MAP NO. Additional ZONING LAND USE LOT CVG % Permits Required REPORT BIMS FEE MISC FEES TOTAL FEES CODE FRONT PLANS VALUE OF CONSTRUCTION REVIEW COUNTER ZONING SUPERVISOR EXAMINER VEGETATION USING ICC TABLE DATE q �p COMPLETE !�% q �(2•ob ��3� ��, INITIALS CERTIFICATION: This applieation is hereby made is order to obtain a permit to do the work and installations as indicated, and to obtain -a certificate of capacity, if applicable, for the permitted work. -- --NOTICE TO, OWNER: _,._FAILURE TO RECORD A• NOTICE OF COMMENCEMENT MAY RESULT IN YOU -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. NOTdCETO'APPLICANT: -IN-THE-EVENT -IT- IS NOT YOUR RIGHT TITLE_ -OR. INTEREST -THAT- IS SUBJECT TO - ATTACHMENT, THE APPLICANT DOES HEREBY MAKE A GOOD FAITH PROMISE TO -- DELIVERr-A-OP—MP—OF—TIMATTACHED—CONSTRUC ION LIEN LAW NOTICE TO THE - PERSON WHOSE PROPERTY IS -SUBJECT TO ATTACHMENT, AND DOES SO AS A - - ------------ —-------------------------•-CONDITION-PRECEDENT-T-O-THIS-P-ERMI-T---- --- . 1. If utilizing the AAF Guide to Aluminum Construction in high Wind Zones, I the Contractor/Owner Builder hereby certify that the components being used, fasteners type and fastening pattern meet all the requirements for the designated wind zones-desby the coanty and -take full responsibility for complying with the submitted designofthe-structure being permitted. 2. I further certify that all the foregoing information is accurate, that no work or installation has commenced prior to the -issuance -of a -permit and that all work shallbe performed -in compliance with all applicable laws regulating -construction -and zoning in .this jurisdiction. I -understand that separate permits maybe required for ELECTRICAL, and HVAC, etc., not otherwise included with this building permit application. 3. I , the Contractor / Owner Builder, have verified that the existing foundation meets the requirements of the Engineer of Record and is in adequate condition to withstand the uplift and weight of the aluminum structure and said structure will not exceed the footprint of the structure that w 4m existence prior to removal by the storms. © R OR CONTRACThR SIGNATURE CONTRACTOR SIGNATURE STATE OF FL RIDA COUNTY OF 2 k, L U 6 9,' - The foregoing instrument was acknowledged before me me this 3t day of Ste, 20_QL, by COaC6\ S1nat�) who is personally known to me, or who has -� produced S 00 a 10 Lk l l d3 d as identification. PL DEANNA GIVENS B Notary PubligS a of Florida Signature of Notary ; •II My Comm. Expires Dec 16, 2016 Commission # EE 858761 IORTANT NOTIC '' %°� a Bonded Through National Notary Assn. MP STATE OF FLORIDA COUNTY OF The foregoing instrument was aclsrfowledged before me me this day of by who is personally i produced as idenf/ication. ignature of Notary 20 to me, or who has (Seal) !t... TWO-_(2)_SIGNA�TURES_.ARE REQUIRED. EACH SIGNATURE MUST BE NOTARIZED. IF APPLYING FOR THIS BUILDING PERMIT AS AN OWNERBUILDER, THE OWNER MUST PERSONALLY .APPEAR, IN THE OFFICE LISTED ON THE FRONT OF THE APPLICATION, TO SIGN THIS APPLICATION &c THE OWNERBLDR AFFIDAVIT. • ALL SIGNATURES ON APPLICATION SUBMITTED SHALL BE ORIGINAL, SIGNED IN INK. COPIES, FAXES, OR STAMPED REPRODUCTIONS ARE PROHIBITED. • WHEN A PERMIT IS AVAILIBLE FOR ISSUANCE BUT IS NOT PICKED UP WITHIN THIRTY (30) DAYS AFTER NOTIFICATION OF AVAILIBILITY, IT WILL BE VOIDED. IF THE APPLICATION IS RESUBMITTED, AN ADDITIONAL FEE WILL BE CHARGED. Property, Appraiser - St.Lucie Coi,r.'q;, FL Page 1 of 1 Carol A Shaw Record: 1 •of 1 Property Identification Site Address: 215 N 39th St Sec/Town/Range: 08 :35S :40E Map ID: 24/08N Zoning: RS-4 Ownership and Mailing Owner: Carol A Shaw Address: 215 N 39th St Fort Pierce FL 34947 Sales Information Date Price Code 10/1 /1975 25000 00 PROPERTY RECORD CARD «Prey Next» Spec.Assmnt Taxes Exemptions Permits Home Print ,��,UCIE CQ Parce]]D: rrro860300 a600 P4 �� Account #: 20636 Use Type: City/Cnty: SF Res Saint Lucie County Legal Description iLBldUi/E - • mm r 029 �f0. j*WR20ZN4y Assessment 2012 Deed Book/Page 2012 Final: 44400 CV 0244 / 2971 Assessed: 44400 Ag.Credit: 0 Exempt: 25000 Taxable: 19400 Taxes: 392.49 BUILDING INFORMATION Total Land and Building Land Value: 7700 Acres: i Building Value: 36700 Finished Area: 1400 SgFt Exterior Features View: - RoofCover: FS - Fibrglss Shg RoofStruct: GA - Gable ExtType: HC - HC YearBit: 1960 Frame: Grade: C - C EffYrBit: 1970 PrimeWall: BS - CB Stucco StoryHght: 0010 -1 Story No.Units: 1 SecWall: - Interior Features BedRooms: 3 Electric: MX - MAXIMUM PrmintWall: DW - Drywall FullBath: 2 HeatType: FHA - FrcdHotAir AvgHt/Fl: 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 Qty, Units Qua]. Cond. YrBlt. No. Use Type Type Measure Depth DWC - Driv-Concret Y 1 760 AV AV 1960 1 0100-SF Res BI -Front Ft Quo FEN4 - CHAINLINK 4' Y 1 250 AV AV 2006 THIS INFORMATION IS BELIEVED TO BE CORRECT AT THIS TIME BUT IT IS SUBJECT TO CHANGE AND IS NOT WARRANTED. http://www.pasle.org/paslc/prc.asp?prclid=240860300670006 8/12/2013 St. Lucie County a l S N 3a4 113J' Building & Zoning lDepartment 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 perrnit 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 ydar 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,�aws, ordinances, building codes, and zoning regulations. Initial I understand that the building official and inspectors are not there to design or give advice on how Ao meet the minimum code. Initial 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 10—L 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 lialbl for the 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 relat edical 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 Owner/Builder Signature f STATE OF FLORIDA COUNTY OF yf , L,o c a 3 �'� The foregoing instrument was acknowledged before me this day of 0 by who is personally known o 5;4 who has DEANNA GIVENS POBr of Florida produced S o O a - 1 O l - i .1(3 -' a as identification. =o�`w� -,, ' Notary Public -State Expires Dec 16, 2016 1� • e ' o` ---%r` of My Comm. Commission # EE 858761 Bon Th ough National Notary Assn. Signature of No ary Type or Print Name of Notary Title: Notary Public Commission Number EWISOVK JOSEPH E. SMITH, CLERK r, THE CIRCUIT COURT - SAINT LUCIE COUNTY__ FILE # 3872362 OR BOOK 15 PAGE 1398, Recorded 09/03/2013 al, :42 PM NOTICE OF COMMENCEMENT Permit No. %I C A - 0 0l 3 Tax Folio No. State of Florida County of St. Lucie The undersigned hereby gives notice that improvement will be made to certain real property, and In accordance with Chapter 713, Florida Statutes, the following Information is provided in this Notice of Commencement. �� Legal D srj% r of lope V: (and street ad ress if available)- Nt! 1 / s + z/431. /.;A7: nnI--ii e2^ei-in IDS!��In W"i 11iW General description of Improvement: S CY t=t- h rD r e i ai4 tl U-j" Owner Inforintion or Jesse inform on if t ssee contracted for the Improvement: Name (h_ Address S Fes• (: T Interest in property: Name and address of fee simple titleholder (if different from Owner listed above): Contractor's Name:l_(.0 IL/L Contractor Address: Phone Number: Surety (if applicable, a copy of the payment bond is attached): Amount of bond: $ Name and address: Phone number: Lender Name: Phone Number: Lenders address: Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(3)(a)7., Florida Statutes: Name: Phone Number: Address: In addition to himself or herself, Owner designates of Llenor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Phone number of person or entity designated by owner: to receive a copy of the Expiration date of notice of commencement: (the expiration date may not be before the completion of construction and final payment to the contractor, but will be 1 year from the date of recording unless a different date Is specified) WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART 1, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. Under penalty of perjury, I declare that I have read the foregoing notice of commencement and that the fads stated therein are true to the best of my kno ledge and belief. I • 44 A 0'j (Signature of Owner or Lessee, or Owners or lessee's Authorized Officer/Director/Partner/Manager (Signatory's Title/Office) ri The foregoing Instrument was acknowledged before me thfs=day of 6� , 20 By CAI[b\ST�dr� as dwh'.r for P1r'3P%r- 3 6W&tf- Name of Person Typejgf t ri ]FW ustee) Party on behalf o whom Instrument was executied • w,.DEANNA GIVENS '� tirL Notary Public - State o1 Personally known_or produced Identiflcation_ (Signature of Notary Public - State o I •'s My Comm, Expires Doc 1(Print, Type, or Stamp Commission taravialis)lon 0 EE OSType of Identification produced SOOo- M,41-1 Os-p Dv M Through National No %# .a v J ft- I%r s qR ■ mac: f/�r ' CD 10, s+ Alm qr h f..1 4 xY„ I ' � R."yI�-)r ��' 1, _ - - ���:' a _ Cam+,. �� �• � Y.d _ �, �� e r `• �,� _ � � "�- _ � _ i! '� � � � - ' Cam'- j. ._ �� � t<; k£ � ' f•. ---T-- it ' _ _� _ 4.1, .. 1=' J . ar I % Tl � J Ss.a °i' � , ' ',.- _: , - ,. k �l �z �.Y�. i � �• '.� M `� - ,.- 4 _ .t _.. }! '�:�.A : r'S 'wS+t ��aifcti� r - 1�'::� '•�`__:. a ''" .t,- -.- y . >-:- �?`7'�`J-�J-1"""`'�s"� �. ),- a - ;S R! %�_aZ;ji ° _,. Y_Y' J I •Y- A 1 I p f h { Ay I F ,�: -CI .�, ,• � ! ; f,, t `� .yislr* :� 3 tx 'Jc'1.{n �' a ��.;' - j� _ _ ' N,39TH ST 11, L?LO" MIN, SETBACK REO, SIDES FRONT' IDES 7 CNR SIDES IREAR P L A ZNG. TECH. copy