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Home My WebLink AboutSUBMITTED PAPERSDate: t Fee Duez- Receipt# Permit # Planning & Development Services Building &Code Regulations Division 2300 Virginia Ave. Fort Pierce, FL 34982 (772)462-1553 SPECIALTY PERMIT APPLICATION ❑ Electrical ❑ Plumbing ❑ HVAC ❑ Fence SCBVtVE® [3 Shed ❑ Demolition ❑ Gas ❑ Siding St' LuC►e County Seepage 2 for instructions and additional paperwork required for specialty permits 1. Location/Site Address: 0 L� 7 () /I ItI, F- - P %J - t L 2. Parcel ID Number: *3 9-4 Z-& 6J'- o 6 7 9- .. O° a - c� Office Use Only Section Township Range Map Page Zoning Land Use Initials 3. Complete Description of Project or Work: h e t-- C- '� 4 �✓ n n✓ 4. Owners Information 5. Contractors Information Name: J 'fie F' �+ ''► P . k & ,, e FL Reg/Cert #: Address: 10 0-3-7 C k, i c c- t' County Cert#: r C City: State: _ Business Name: - �<DO ` a' Zip: ? 5` �1 ? Phone: ; ' (,I, -) 7, '1Phone: Fax: 6. Value of Construction: $� o ¢ s w a •� m OWNER's AFFIDAVIT: I certify that all of the information contained in this application is correct and that all work will be d - compliance with all applicable laws regulating construction and zoning. .S4 PRINT OWNER OR CONTRACTOR NAME r SIGNATURE OF OWNER OR CONTRACTOR STATE OF FLORIDA, COUNTY OF ACKNOWLEDGED BEFORE ME THIS J—DAY OF �i20BY I% C WHO IS PERSONALLY KNOWN TO ME OR WHO HA PODUCE D �- AS IDENTIFICATION. UA9&44t� SIGNATURE OF NOT Y TYPE OR PRINT NAME F 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 WITH CONTRACT UNDER $7500.00 Revised 04/26/2010 NOTICE TO OWNER: FAILURE T( 'CORD A NOTICE OF COMMENCEMENT M,' '!ESULT IN YOUR PAYING TWICE FOR IMPROVEML..: i TO YOUR PROPERTY. IF YOU INTEND--,,,, 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) or typed. This permit application is' to be used only for those activities that are not otherwise included building pemiit. This application may not be used for any activity that includes stnictural 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 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. P. ❑ 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 can 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 processing after 4:30 P.M. For assistance in completing this application, please call (772) 462-15 3, during regu ark office -hours (8:00-AM-= 5:0O-PNI),'Mon ay t -- oug --- -r ay.- ----- - 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.Coul'` , 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 lidensing 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**Y � I understand that the building official and inspectors are not there to design or give advice on h 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. Initial 46S 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 hake 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 IVS ✓ 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 Dep t o theFlorida State Department of Professional Regulation.. Signed and acknowledged on this 4L day o of 20. OwnerBuilder Signature 41FA1I_XIMiF67 COUNTY OF R/A The f egoing ins ent was ac wledged before me this jl day of , 20/_, by /7 i who is personally known to me, or who has produced r', as identific on. hr Si e of Notary Type or Print e o Notary Seal) Title: Notary Public Commis- io umber REY B. HUMpHpEY * flhY CC? # rE 061159 EXPIRES- March G 20 1,5 c ?' Bonded 7hru Notary PuhIIC Undenvriters T Kl- Sr.:LUCI COUNTY UTILITIES -P.O. BOX 728, FM PIERCE, FL 34982 SEWER,, 1 RES -NAMIE METER SZ-.' I%ff ACCT. # jj�IRIR Z)SECURITY $ DEP SERVICEADDR ESS SERVICE FEE ON TCLc5 LOt' BLOCK SAME DAY FEE SUBDIVIS ..OVERTIME FEE., BILLING ADDRESS '� f4 CA. el A 9 !CI. 1/) METER INSTALL. L CFCIWATER i 4 -Z� -FPUk CFC, PHONE# MOVE IN/CLOSING DAAA CFC/SEWER GUAR. REV. This application an hereby request d authorizes the Utility; to. render water and/or sewage disposal services to the premises described above in accordance with the Utilities pre -sent or future rates, LATERAL -AL rules and regulations, the Utility which by ref6rence are made a part o.0 this contract: Applicant agrees to pay promptly for such services in accordance with the established, rules and regulations. $ TOT CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE:. CUSTOMER SIGNATURE SOCIAL SEC/ FED ID Jos 2 NAME OF SPOUSE SPOUSE SOCIAL SEC. DATE RECEIVED,"-,-; OFFICE USE ONLY 7; �- ,(' ' "- ; i /I ) I . ;4 W'L " CASH CHK # —1 1 RECEIVED BY Property Appraiser - St.Lucie (vv -- nty, FL Y Page 1 of 1 Stephen P Kane Record: 1 of 1 Property Identification Site Address: 4711 MYRTLE DR Secrrown/Range: 02 :36S :40E Map ID: 34/02N Zoning: RS-4 Ownership and Mailing Owner: Stephen P Kane Address: 1022 Andrea Ln Okeechobee FL 34974 PROPERTY RECORD CARD <<Prev Next» Spec.Assmnt Taxes Exemptions Permits Home Print ParcellD: (L,6QSOQ4;000 8 y� G,L� Account #: 37197 Land Use: SF Res City/Cnty: St Lucie County Legal Description INDIAN RIVER ESTATES -UNIT 07- BLK 39 LOT 19 (MAP 34/02N) (OR 3395-1109) Sales Information Assessment 2011 Final Total Land and Building Date Price Code Deed Book/Page 2011 Final: 33200 Land Value: 6900 Acres: 0.23 5/24/2012 21700 0112 DE 3395 / 1109 Assessed: 33200 Building Value: 26300 11/9/2011 0 0112 SP 3340 / 1129 Ag.Credit: 0 Finished Area: 1194 SgFt 9/22/2010 102000 0112 CT 3256 / 2424 Exempt: 3/4/2008 94900 01 SP 2995 / 0675 Taxable: 8/16/2007 100 01 CT 2867 / 0408 Taxes: 675.48 5/31 /2006 153500 00 WD 2616 / 2721' 11/20/1988 100 01 QC 0612 / 1102 12/1/1987 32000 00 CV 0570 / 0927 9/1/1987 28400 01 CV 0557 / 1819 9/1/1980 37500 00 CV 0338 / 0824 9/1/1980 20800 00 CV 0338 / 0823 BUILDING INFORMATION n (uo) le to u BLS (IIM) Exterior Features View: RoofCover: ExtType: HC- - HC- YearBit: Grade: C- - C- EffYrBlt: StoryHght: 0010 -1 Story No.Units: Interior Features BedRooms: 2 Electric: FullBath: 1 HeatType: 1 /2Bath: 1 HeatFuel: %A/C: 100 %Heated: Special Features and Yard Items Type Y/S Qty. Units Qual. Cond FEN4 - CHAINLINK 4' Y 1 180 AV AV FS - Fibrglss Shg RoofStruct: GA - Gable 1973 Frame: - 1973 PrimeWall: WS - Wood/Sheath 1 SecWall: - MX - MAXIMUM PrmintWall: DW - Drywall - FHA - FrcdHotAir AvgHt/FI: ELEC - Electric Prm.Flors: CU - Carpet 100 %Sprinkled: 0 Land Information YrBlt. No. Land Use Type Measure Depth 1973 1 0100-SF Res BI -Front Ft 80 125 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=340260800740008 6/11/2012