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Home My WebLink AboutSUBMITTED PAPERSDate: ee Due:—, "ermit # VJ Planning & Development Services Building & Code Regulations Division 2300 Virginia Ave. 0 MI. Fort Pierce, FL 34982 SPECIALTY PERMIT APPLICATION ❑ Electrical M Plumbing ❑ HVAC ❑ Fence ❑ Shed ❑ Demolition ❑ Gas ❑ Siding Seepage 2 for instructions and additional paperwork required for specialty permits 1. Location/Site Address: lei, T ,Gyd-`r- F��i' 2. Parcel ID Number: SC �V1VSD St. Lucie C®un ty Office Use _ i5W! SK 3. Complete Description of Project or Work: 4. Owners Information 5. Contractors Information Name: �p�c� �.- �'t/ul1. MGM' FL Reg/Cert #: Address: 4.3pLf County Cert#: City: piy --C, State: Business Name: Zip: .3g9y7 Phone: 7-/02-q(6 Jay/ Phone: Fax: 6. Value of Construction: $ 4 66) - 0 0 1� 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 regu Z g construction and zonin . PRINT OWNER O CONTRACTOR NAME %% SIGNATURE OF OWNER CO STATE OF FLORIDA, COUNTY OF ACKNOWLEDGED BEFORE ME THIS �� DAY OF I—T20 L . BYI_7_e��Jr ADc,_, _ WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED ENTIFICATION. CAv^^ ` MY ANG *: HUFF -- ---- - --- - - of -- --. --#EE083530 -- SIGNATURE OF N ARY TYPE OR PRINT NAME OF NOTARY ...-0 EXPIRES: April 12,2015 Bonded Thru NOfary public 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 WITH CONTRACT UNDER $7500.00 Revised 04/26/2010 NOTICkTO-OWNER: FAILURI�- ""`a RECORD A NOTICE OF COMMENCEMENT 1, RESULT IN YOURI PAYING TWICE FOR IMPROV ., 5"NTS TO YOUR PROPERTY. IF YOU INTENL ,) OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. EXEMPT: A/C -HEAT REPLACEMENT WITH CONTRACT UNDER $5,000. INSTRUCTIONS. Please complete all information in the space provided. All information must be printed (use black or blue ink only) ortyp-ed. This permit application is to be used only for those activities that are not otherwise included 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 activity is taking 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 righfto 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. ❑ 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 ❑ 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 cart be, submitted to St. Lucie County -Building and Zoning, 2300 Virginia Avenue, Fort Pierce, FL 34982. All permit applications must. be filled out completely before submission. No applications will be. accepted for processipg after 4 30 P.M. For assistance in.completing this .application, please' call (772), 462=13; dorm— re areours 8:00 A1VI-- 5:00 P 1Vlonda tlirou h"Fricta {.. g 8u ... ( M)� y g y NOTE. Emergency electric service change out inspections will not be 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. St. Lucie .Coun'iy Building & Zoning Department 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 applicable laws, 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 to 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. e. Initial .�0 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 liable 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 related medical 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 wneAuhder Signature f STATE OF FLODDA r t COUNTY OF /,, The oregoing instnune t was ac owledged before me this � day of-7 , 20A_, by who is personally known to me, or who has produced — --C) as identification. An Signature Notary Type or Prilitlame of Notary ;..... ,ANGEF Title: Not ry Public Commissio ber `_*; MyEXPIRES: l `�'083530 •oe EXPIRES:: AApril 12,-2015 '•'.;F eF h�`Cd ry Bonded Thru NotaPublic underwriters Property Appraiser - St.Lucie C- °-nty, FL Page 1 of 1 lzear Avant Record: 1 of 1 Property Identification Site Address: 4304 Avenue Q Sec/Town/Range: 06 :35S :40E Map ID: 24/06N Zoning: RS-4 Ownership and Mailing Owner: Address: Sales Information Date Price 8/27/2007 100 11 /2/1999 100 9/1/1977 2000 PROPERTY RECORD CARD «Prey Next» Spec.Assmnt Taxes Exemptions Permits Home Print �,UCIE C G ParcellD: 2406-113-0002-000-3 Account* 19289 y Land Use: SF Res City/Cnty: St Lucie County Legal Description Izear Avant Martha Lee Avant 6 35 40 FROM INT E RAN LI N EMERGENCY RELIEF CANAL AND N 4304 Ave Q R/W AV Q, SD PT BEING POB, RUN NELY ALG SD Fort Pierce FL 34947-7043 More... Assessment 2011 Final Total Land and Building Code Deed Book/Page 2011 Final: 65400 Land Value: 11200 Acres: 0.45 01 QC 2871 / 1682 Assessed: 65400 Building Value: 64200 01 QC 1260 / 1429 Ag.Credit: 0 Finished Area: 1756 SgFt 01 CV 0275 / 1920 Exempt: 65400 Taxable: 0 Taxes: 408.86 BUILDING INFORMATION • Exterior Features ' ° ov°e a ¢° View: - RoofCover: SA - Asph Shingle RoofStruct: GA - Gable ExtType: HC- - HC- YearBit: 1988 Frame: - Grade: C- - C- EffYrBit: 1988 PrimeWall: SS - 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: STD 1/213ath: 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 Qual. Cond. YrBlt. No. Land Use Type Measure 4CFT - 4CFT S 1 1 AV AV 1988 1 0100-SF Res BI -Front Ft 161.25999 3CFT - 3CFT S 1 1 AV AV 1988 SDSF - SITE DEV S-F Y 1 1 AV AV 2001 THIS INFORMATION IS BELIEVED TO BE CORRECT AT THIS TIME BUT IT IS SUBJECT TO CHANGE AND IS NOT WARRANTED Depth 134 http://www.paslc.org/paslc/prc.asp?prclid=240611300020003 6/5/2012 Fort Pierce Utilities Author Vr "Committed To Quality" Key Accounts /00SS 3�`"C�!1�1.- / 206 S. 6th Street Fort Pierce, FL 34984-3191, Phone (772)466-1600 Fax (772)465-6984 Job Location: 4304 AVENUE Q Invoice Number: KA-69-12 Account Name: IZEAR AVANT PCN: 240611300020003 Contact Name: IZEAR AVANT FEI# Billing Address: 4304 AVNEUE Q FT PIERCE FL 34947 Phone: (772)466-1791 Fax: O - Cell: O - 'Cust Type Residential City Limits Outside 5.s^ C7:."'K'9 _,-'?i` do -Accountf>ng, Codes#S%e� y$�''°-`a,..; ayalr-{ ro ..,.F s. "'Y�".:i^r;e < y.,�u. 4 �'Uescrtptror� L� f"Yr �'�tL'+�y. •'�5-fin xk5� a•$- ,�,� _S gees: g r� e� Rom.._ Ma. 06-3-060-43701-0000 1 5/8 X 3/4" Water Meter and/or Service Installation $250.00 06-2-000-23500-0000 Water Security Deposit $60.00 06-3-060-48800-0000 Water New Account Setup Charge $40.00 06-3-060-43702-0000 Water Capital Improvement Charge W ERC's 0.00 -$0.00 06-3-060-49525-0000 *Water Accrued Guaranteed Revenue Charge. $0.06 Meter Verification Fees $0.00 08-2-000-23500-0000 Wastewater Security Deposit $0.00 08-3-080-48800-0000. Wastewater New Account Setup Charge $0.00 08-3-080-43702-0000 Wastewater Capital Improvement Charge WW ERC's 0.00 $0.00 08-3-080-49525-0600 *Wastewater Accrued Guaranteed Revenue Charge $0.00 Lien Fees 0.00 �.,'k::." 3 �i-�. ;: < c:.:w;d'"" .tom a'%s-r",,,, �4ccou�t�n kCodes r '+'+.:s�=4. { �a'"� ., ,, r � t�•'-r-:,:'v�, 3:"�� Ghae:;:�v.7 t:�=-�t� .. - C,:..os+-'Fsfi:.m�a atet�7 - in "� .`�'' �- 5»+.,i4a �.. " �^'t j"iv .w s e"•-- wu3e ^.�2 0.00 0.00 at�and W steal ter AGRC fees are pod Until tote end of�r t e m rh If ' a Ived b ; , " R t a g y Down Payment: $0.00 the ofthe fees Please contact our afiice for updated fees �' end month, new wlli,apply Invoice Total: $350.00 Description for service order: INSTALL 5/8 X 3/4" WATER METER ONLY Total Paid: P V v Date Paid: Check Number: Customers will be assessed wastewater charges the day they connect to the wastewater system or within 365 days from date wastewater Connection Charge is paid - whichever is first The cost of the service line from the point of delivery at the property line to the house/building is the responsibility of the customer and is not included in this invoice. State laws require that a permit from the Health Department must be obtained prior to initiating a septic tank abandonment. Contact the Health Department at (772)873-4931. Construction cost estimates are based on current labor, equipment and material prices. Actual costs of construction will be determined at the completion of the project. Should unforeseen circumstances be encountered during construction, including but not limited to adverse weather conditions and construction conflicts, the customer will be responsible for increased costs. Additional costs incurred by the customer shall not exceed fifteen (15) percent of the total estimated construction costs shown above. Estimated costs paid by the customer that exce a actual cost of construction will be refunded by Fort. Pierce Utilities Authority. Reviewed By: Joyce Easterday Key Accounts Specialist Date: 05/15/2012 Customer's Signature: Date: Printed Name: