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Home My WebLink AboutSUBMITTED PAPERSTee Due. Permit # ""� Electrical ❑ Shed Planning & Development Services Building & Code Regulations Division 2300 Virginia Ave. Fort Pierce, FL 34982 (772)462-1553 SPECIALTY PERMIT APPLICATION ❑ Plumbing ❑ HVAC ❑ Fence ❑ Demolition ❑ Gas ❑ Siding Seepage 2 for instructions and additional paperwork required for specialty permits 1. Location/Site Address: pq l c (A , 2. Parcel ID Number: 2-11 t) l6 -- t-i t4 — ®o o 9— a o 00 — f l 20grO y6b Office Use Only Section Township Range Map Page Zoning Land Use Initials 3 ` „11 3. Complete Description of Project or Work: 2�, Y" e---C ✓ 61 x 4. Owners Information 5. Contractors Information Name: (� �� p r �„� C) ( C, FL Reg/Cert #: Address: 9 [l County Cert#: City: Zip: State: _ L Business Name: 34.Ci � Phone�� 7 2 72) r 'S� �Phbne� Fax: G 6. Value of Construction: $ zso d Q OWNERS 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 regulating constru ' z ' g. —PRINT OWNER OR CONTRACTOR NAMESIGNIITURE O NTRACTOR STATE OF FLORIDA, COUNTY OF ACKNOWLEDGED BEFORE ME THIS V V DAY OF aald , 20,,0 — BY e,44" D,4am, WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED AS ID IFICATION. 1 OF NOTARY COMMISSION NUMBER PRINT NAME OF NOTARY DAWN MILONE MY COMMISSION # DD 62013, 021 S EXPIRES: M' $� 6onded7hruNotarytI Underwriters 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 TG,=�WORD A NOTICE OF COMMENCEMENT M1"' ,DESULT IN YOUR PAYING TWICE FOR IMPROVEMI TO YOUR PROPERTY. IF YOU INTEND )BTAIN FINANCING, CONSULT WITH YOUR LEND`rn OR AN ATTORNEY BEFORE RECORDING YOuA nOTICE OF COMMENCEMENT. EXEMPT: A/C -BEAT 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 under a primary�building permit. This application may not be used for any activity that includes structural 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 buiiding/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. ❑ 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). 462-1553, duringregular office hours (8:00 AM - 5:00 PM), Monday through Friday. 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 County 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 1:2 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. Initial I understand that if I compensate any person orcompany 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 �- j 1 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 rida State Department of Professional. Regulation. Signed and acknowledged on this day of i I of 20 r- wner/Builder Signature F STATE OF FLORID COUNTY OF r The foregoing instrument was a owledged before me this1D day of� , 20�� Ziganature who is personally known to me, or who has as identification. ;'� DAWN MILONE `*' *E MY C C %l OMMISSION N DD 852587 -'� �' EXPI Notary Type or Print Name of Notary gti ; ti° '�• bondedary Tn o a u 2013 rs Title: NotPublic Commission Number Public Planning & Development Services Department • Building & Code Regulations Division o 2300 Virginia Ave _ Fort Pierce, FL 34982 772-462-1553 Owner Builder Affidavit — Electrical Contracting DISCLOSURE STATEMENT F.S. 489.503 (6) EXEMPTIONS State law requires electrical contracting to be done by licensed electrical 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 electrical contractor even though you do not have a license. You may install electrical wiring for a farm outbuilding or a single-family or duplex residence. You may install electrical wiring in a commercial building the aggregate construction costs of which are under $75,000. The home or building must be for your own use and occupancy. It may not be built for sale or lease. If you sell or lease more than one building you have wired yourself within 1 year after the construction is complete, the law will presume that you built it for sale or lease, which is a violation of this exemption. You may not hire an unlicensed person as your electrical contractor. Your construction shall be done according to building codes and zoning regulations. 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. Failure to do so may result in a liability for you! To qualify for this exemption under this subsection, an owner must personally appear and sign the building permit application. 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 Community Development Director to the Florida State Department of Professional Regulation. Signed and acknowledged on this 3(D day of 20 f,: . OWNER/BUILDER SIGNWTURE STATE OF FLORIDA COUNTY OF t The foregoing instrument was acknowledged -before me this b day of k , 20 -1_2__1 r by A _QAfQ� , who is personally known to me or f~ n 1\ roduced 1 n Signature of Notary Print name of Notary Title: Notary Public Commission Number SLCPDSD Revised 7/23/2010 as identification. -, OAWN M ILONE -- MY COMMISSION # DD 852587 FXIRES:Bonded Thru 140t ryarch PubUC UZmnitem St. Lucie County Owner Builder Affidavit -Electrical Contracting Property Appraiser - St.Lucir- '-)unty, FL Page 1 of 1 PROPERTY RECORD CARD Camerino Diaz Record: 1 of 1 <<Prev Next» Spec.Assmnt Taxes Exemptions Permits Home Print Property Identification ��UCIE CO Site Address: 915 Angle Rd ParceIID: Mll- 41-0002-000z_1 G Sec/Town/Range: 06 :35S :40E Account #: 19353 yQ12 Map ID: 24/06S Land Use: SF Res Zoning: IL City/Cnty: St Lucie County Ownership and Mailing Legal Description Owner: Camerino Diaz 6 35 40 BEG ON N LINE OF SE 1/4 OF SE 1/4 AT W R/W OF ANGLE Address: 915 Angle Rd RD, TH RUN SELY ALONG RD 102.4 FTTO S SI Fort Pierce FL 34947-1701 More... Sales Information Assessment 2011 Final Total Land and Building Date Price Code Deed Book/Page 2011 Final: 68000 Land Value: 45700 Acres: 0.35 5/22/1998 31500 01 WD 1147 / 1727 Assessed: 42745 Building Value: 22300 1/31/1996 35000 00 QC 1016 / 2819 Ag.Credit: 0 Finished Area: 1116 SgFt 1/31/1992 43000 01 WD 0774/0909 Exempt: 25000 1/7/1992 42000 00 QC 0771 / 1384 Taxable: 17745 9/18/1990 44000 00 WD 0708 / 0681 Taxes: 361.04 BUILDING INFORMATION Exterior Features View: - RoofCover: ExtType: HD- - HD- YearBit: Grade: D- - D- EffYrBlt: StoryHght: 0010 - 1 Story No.Units: Interior Features BedRooms: 3 Electric: FuliBath: 1 HeatType: 1/26ath: 0 HeatFuel: %A/C: 0 %Heated: Special Features and Yard Items Type Y/S Qty. Units Qual. Cond. YrBlt. SDSF - SITE DEV S-F Y 1 1 AV AV 2001 n r.c s SA - Asph Shingle RoofStruct: GA - Gable 1952 Frame: - 1970 PrimeWall: SB - Abs Shingle 1 SecWall: - AV - AVERAGE PrmintWall: EB - EB AvgHt/FI: STD - Prm.Flors: SP - Sing Pine 0 %Sprinkled: 0 Land Information No. Land Use Type Measure 1 0100-SF Res 307 -Sq Feet 15246 Depth THIS INFORMATION IS BELIEVED TO BE CORRECT AT THIS TIME BUT IT IS SUBJECT TO CHANGE AND IS NOT WARRANTED. http://www.paslc.org/prc.asp?prclid=240644100020001 4/30/2012