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Home My WebLink AboutSUBMITTED PAPERSDate: Fee Due: Recei t# ( Permit # Qly, St. Lucre County Building case .Zoning 2300 Virginia Avenue Ft. Pierce, PL 34982-5652 8 �b Tel. 561-462-1553 Y SPECIALTY PERMIT APPLICATION Cie cc'U/7ty ❑ Electrical. 2-Plumbing ❑ HfVAC ❑ Fence ❑ Shed ❑ Demolition ❑ Gas ❑ Siding Seepage 2 for instructions and additional paperwork required for specialty permits 1. Location/Site Address:M4 &e �� D" 2. Parcel ID Number: Office Use Section Township I Range I Map Page Zoning I Land Use I Initials Only I S 1;3 /J 3. Description of Projector Work Activity:. 4. Owners Information 5. Contractors Information Name: r° rrrl l i'� �'i 7 FL Reg/Cent #: Address: / j _ d�aOQ4 County Cert#: City: State: CL Business Name: Zip: Phone: Phone +F, 6. Value of Construction: $ pq�50 l� O"ER'S AFF[DAVIT: 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 constriction a oning. PRINT QUALIFIERS/OWNERSNAME z SIGNATURE UALIPIER/OWNER STATE OP FLORIDA, COUNTY 0 ? ACKNOWLEDGED BCFOP F- ME TI1IS / DAY Or pry f� Q4�, 20A�BT J f-11 �/y C1 'nWHO IS PERSONALLY KNOWN TO ME OR WI-10 HAS PRODUCED I / t/ 1 �!_L.Ci(i(� AS IDENTIFIC "ION. i/ (seal) SIG A? J1 r OF N0'rARY TYPIi 01 I'RIN'r NA ? I NOTARY t\' TITLE: NOTAR P1113LIC OMMISSION NUM111M " B. HUMPHREY raUDREY pv� FY ,w MY CC JMISSIOAI # EE 051159 <: EXPIRES: Match 6, 2015 Notary Public UndeTw6ters •'�Ti •F i OQ`Bonded Thru St. Lucie County Specialty c ig Planning & Development Services Department Building & Code Regulations 2300 Virginia Avenue Fort Pierce, Florida 34982 (772)462-1553 OWNERBUILDER 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 applicabl , ws, 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 et 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 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 f r e cost of the license. Initial V 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 a ical 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 Departmprit to the Florida State Department of Professional Regulation. Sign � and acknowledged on this day o of 20 /. O er/Buil er Si ure STATE OF FLORIDA �- COUNTY OF The f going instrume was cknowledged before me this day of 120 , by �•,�y�/ �/' j n who is personally kno to me, or who has ..,..,.,a 71 /1 r7 , ,: as identification. Signature of otary ge or Prmt Name'of N ary (Seal) Title: Notar ublic Commission Number 1pPY'PUB 4� AUDREY B. HUMPHREY SLCPDSD Revised 07/22/2010 `; MY COMMISSION # EE 061159 ^i `a EXPIRES: March 6, 2015 Bonded Thru Notary Public Underwriters SOCIAL SEC/ %/4 FED ID SPOUSE SOCIAL SEC... I Sri a N TY UTILITIES P.O BOX 7 - ' FT.: PIERCE FL 34982* —RES ST. LUCIE, CO UT .i SEWER METER SZ. IRR. ACCT, A , SECURITY DEP SERVICEADD SS SERVICE FEE SAME DAYFEE J—�ter,L, -r'2-7-tLOCK OVERTIME FEE SUBDIVISION BILLINGADD W'o 0 V METER INSTALL. SS CFC/WATER T— FPUA CFC PHONE -7 MO IN/CLOSING DATE. CFC/SEWER This al 3plication-1 i iereby request and authorizes the Utility to render water and/or sewage disposal GUAR. REV. 'dance with the Utilities present or e rates, services to the prernises described above in accor futur I . I I �1 . , rules andregulations, which by reference ,afe ma,dp:a Partof this, contract. Applicant agrees to pay LATERAL' TOTAL the Utility promptly for such services in�* accordance with the established rules and regulations. CUSTOMERS DEPOSITS ARE N014 NEGOTL? BLE OR TRANSFERABLE. 'USTOMER aGNATURE DAME OF SPOUSE OFFICE USE ONLY h I r A QT-T CHK # RECEIVED Property Appraiser - St.Lucie County, FL Page 1 of 1 `? PROPERTY RECORD CARD Edward R Eichin Record: 1 of 2 <<Prev Next » Spec.Assmnt Taxes Exemptions Permits Home Print Property Identification �vOCIEco Site Address: 6106 Buchanan Dr ParcellD: 3402-603-0146-000-9 Gi Secffown!Range: 11 :36S :40E Account r: 36677 y� Map ID: 34/11S Land Use: SF Res Zoning: RS-3 City/Cnty: St Lucie County Ownership and Mailing Legal Description Owner: Edward R Eichin Sherry S Eichin INDIAN RIVER ESTATES -UNIT 02- BLK 11 W 100 FT OF S 52 FT OF Address: 6106 Buchanan Dr LOT 21 AND W 100 FT OF LOT 22 (MAP34/11S Fort Pierce FL 34982-3213 More... Sales Information Assessment 2010 Final Total Land and Building Date Price Code Deed Book/Page 2010 Final: 77700 Land Value: 17400 Acres: 0.35 10/4/1996 74000 00 WD 1039 / 2144 Assessed: 77700 Building Value: 60300 5/29/1992 68000 00 WD 0793 / 2884 Ag.Credit: 0 Finished Area: 1545 SgFt 4/1/1983 9000 01 CV 0400 / 2694 Exempt: Taxable: Taxes: 1614.94 BUILDING INFORMATION Exterior Features View: RoofCover: FS - Fibrglss Shg RoofStruct: HP - Hip ExtType: HC- - HC- YearBlt: 1983 Frame: Grade: C- - C- Ef fYrBlt: 1983 PrimeWall: WS - Wood/Sheath 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: 1/2Bath: 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 Depth DWC - Driv-Concret Y 1 400 AV AV 1983 1 0100-SF Res BCS -Front Ft 151 100 FEN4 - CHAINLINK4' Y 1 150 AV AV 1983 FNV3 - VINYLFENCET Y 1 54 AV AV 2000 THIS INFORMATION IS BELIEVED TO BE CORRECT AT THIS TIME BUT IT IS SUBJECT TO CHANGE AND IS NOT WARRANTED U (O bttp://www.paslc.org/prc.asp?prclid=340260301460009 7/11 /2011