HomeMy WebLinkAboutSUBMITTED PAPERSDate: Al,,,/ Fee Due: `�� % Receipt# 'Imit #
- Planning & Development Services
Building & Code Regulations Division,.
COUNTY2300 Virginia Ave.. q9c
r A Fort Pierce, FL 34982
(772)462-1553 St e y F®
`4��� Co
SPECIALTY PERMIT APPLICATION �ntk
❑ gwrical
Shed
See page 2 for lnstrucdons and addwonal paperwork requfred for specially permits
1. Location/Site Address:
2. Parcel ID Number:
❑ Plumbing ❑ flVAC ❑ Fence
❑ Demolition ❑ Gas ❑ Siding
Township
Range
Map P e
Zoning
Lead Use
Initials
Office .Use
only
Section
S
139EWIL'Ar"
.
7
s1 /% A
3. Complete Description of Project or Work: /t!i/ -�
4. Owners
Name:
Address:
City: �� State:
�%✓
zip: Phone:
Information
g/Cert #:
y Cert#r
Business Name:
Phone:— Fax:
6. Value of Construction: S,
OWNWS 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 regnlatin o kd PR1N O C OR ozvt_ - SIGNA OF O ONTRACTOR
STATE OF FLORIDA. COUNTY OF n( l LC
(�
ACigNoWLEDGED BEFORE ME THIS / U DAY OF i 20 BY / ( 7`
WHO IS PERSONALLY KNOWN TOME OR WHO PRO CED�
AS ATION.
SI OFNOTARY
commisSION NUMBER
�V1 ;"1 Jg ,y oAWNM
MY CAMMISSI 852587
NAME OF NOTARY i 2r EXPIRES; March 22, 2013
a, •... Owdod ThN �,y Public underem m
Bf�
NOTICE TO OWNER FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR
IMMOVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR
LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMIYIENCEMENT.
EXEMPT: AIGHEAT REPLACEMENT WITH CONTRACT UNDER $5,000.
NOTICE TO OWNER FAD, ' °'! TO RECORD A NOTICE OF COMMENCEN - `NAY RESULT IN YOUR PAYING TWICE FOR
BM?.'-:^EMENTS TO YOUR PROPERTY. IF YOU O1, D TO 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
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
buildingleonstruction activity. Construction value is
usedlo 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 siie,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 -fall 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)
462-1�553', during regular office hours (8:00 AM - 5:00 PM), Monday through Friday.
NOTE..Emergency electric service change out inspections will not be performed after 3: DO PM without
special arrangements and additional fee paid.
Upon issuance of this permit, required inspections can be scheduled by calling (772) 462-1261.
J J r Planning & Development Services Department
Building & Code Regulations
2300 Virginia Avenue
� — R Fort Pierce, Florida 34982
k (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 applicab e
ordinances, building codes, and zoning regulations. Initial
I understand that the building official and inspectors are not there to design or give advice on $OM4
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.
Initia
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 liab
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 rAatem&edal
cost, which could include loss of wages during recovery from their injury. Initia
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
,tdayDep tmen to the Florida Stal Department of Professional Regulation. Signed and ac ledged on this
of of 20 1 .
Owner/Builde S tore
STATE OF FLORID
COUNTY OF °
beytb%g! ijs!,rp tl ads agknowledged
Signature of Notary
Title: Notary Public
SLCPDSD Revised 07/22/2010
before me this 1 v day of
who is personally kno who has DAV ' :!t
as identificatio MY�OMMsS> OD852587
2, 201S
Bonded�Th'?!}s,w t.1nA6M1Yili4lk f
ti �riiri
MYCOXr1t me of Notary (Seal)
MMISS
EXPIRES:
Bonded Thru Notary Public
Property Appraiser - St.Lucie County, FL
Page 1 of 1
i
PROPERTY RECORD CARD
Ronald W Pollock Record: 1 of 1 <<Prev Next» Spec.Assmnt Taxes Exemptions Permits Home Print
Property Identification
Site Address:
6605 PASO ROBLES BV
ParcellD:
1301-611-0346-000-0
����1Cfi00G'-
Sec/Town/Range:
01 :34S :39E
Account*
2714
Map ID:
13/01N
Land Use:
SF Res
Zoning:
RS-4
City/Cnty:
St Lucie County
Ownership and Mailing
Legal Description
Owner:
Ronald W Pollock Augusta O Pollock
LAKEWOOD
PARK -UNIT 9- BLK 116 LOT 19 (MAP 13/01 N) (OR 486-
Address:
6605 Paso Robles Blvd
2182
Fort Pierce FL 34951-1274
Sales Information
Assessment 2010 Final Total Land and Building
Date Price Code Deed
Book/Page
2010 Final:
66100 Land Value: 9900 Acres: 0.27
12/1/1985
64500 00 CV
0486 / 2182
Assessed:
66100 Building Value: 56200
9/1/1974
34600 00 CV
0231 / 2616
Ag.Credit:
0 Finished Area: 1506 SgFt
Exempt:
41100
Taxable:
25000
Taxes:
651.27
BUILDING INFORMATION
M
Exterior Features
View:
-
RoofCover:
SA - Asph Shingle
RoofStruct:
GA - Gable
ExtType:
HD+ - HD+
YearBlt:
1974
Frame:
Grade:
D+ - D+
EffYrBlt:
1977
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/FI:
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
3CCT - 3CCT
S 1
1 AV AV
1977 1 0100-SF Res
BI -Front Ft
90
SDSF - SITE DEV S-F
Y 1
1 AV AV
2001
Depth
130
THIS INFORMATION IS BELIEVED TO BE CORRECT AT THIS TIME BUT IT IS SUBJECT TO CHANGE AND IS NOT WARRANTED.
http://www.pasle.org/prc.asp?prclid=130161103460000 7/18/2011
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06/24/2011 13:10 FAX 8636382648 Robin Builders, Inc.
4
STATE OF FLOWDL
DEPARTMENT OF COMMUNITY AFFAIRS
tcl n7a""ing Florida a be:!ei-piae in cailhome'
CHARUE CTST
Gnem.,
October 21 201..".
Lewis Hartk�
Roin BOAM nm - Fl.
Pom OW Box 100, 14915 Hwy 27 S.
L"a Watt A M85:'i
RE, Manuilaurer CeNNO&Q, 110 MF7 55; Exon6on Dam: No,--.
DeN Lew?S H3a%
R * my yinwin to Mum vi'.- ihaz Fmjlloert Vic - Q final 21 PG Ba, 106E "915 Q;
27 5, Lae Watt R. 33651 haS bee! eyMA u"If We M-Ma-K MOM PrQTaW U
)rovide.-I For uricie, Zhaptei* 551 Part 1. FWa Smrul:e, m m=qMWn S-ye HAS:
B-i-Ii1dingq for in Florin.
QnMnation or moM%tonrei a bLj,lWng can"t Uepw uns; so Thad Party
Agencyhas appr,ved the Flans M MWAMM wit Me awmil R010a BOW GA. YU, 10".1,
Palsy Agemy is a cwtimcmi-for tne Depa-rtfrnent and "s sz5tlutory authcrr!:y d ;'eSQonz:bi!itie.--s
mas mat 4 Mato mam'ain SZ3LUS. YOU 17)aV e'y'.PEC' 27:o --H131itv PiEHIS
Cac.h Code change wilirn.ke you' ph& =ete W :.,.ay' have ben anewel appmved aml
masawd [an me me"PN of me mm" 5"oWun. Wth be KU U, P. Third AM'
A-ger-c'?- ",or 012)ri, Mmew Mn- an -I MM YOV WS 2M IMOMY-we V! am PARK
powas on cur &ey"W. M ."over OnNANM isms me nNeo =:"'W& Rou"'f
7nDcDaf-ureriC'-,,. v.!! v.'!-, �, EiC;l
nnqt gant zappere allU5 = yn, mawhcwmg fnav on -mv, to mmyn
irat',)-- is by Zwee Yew& firom %his v':i;
g""Wd by to bus -ye 4�"- K au on Que0=5
preme as, our Stamm at W we nosh nowyn"�p me on%-,
sainamna S06nS VOW&V A
DueGng pemou.
Raben Loona
manufadurec Bymnp
=: National Dengil and Dapeawn,
THIOMAS G. PELHAM
Seywwy
255S SHUMARD OAK RMUS"RO * T"LA"S"V PL 32"9-2100
8W so SH
IQU'Vic' -.ND COMMUNITY DF.Vr.(.0NENT
WJ UUI/ UU0
NOTE.- I OtNrt, RVA NNSN Y'Ap",
PT DOUBLE2M) SKID S. Pj FXdJGJ fML PT V,4 (0)
NDI
APPROVED"
-DOCUMENT
24"OG
FLOOR F :2
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... ......... -1 .... ...... .............. ........ .. . .... ..
1A.T.S. U
374- OR BIG- SP FLYWO013 Modtz!'4r RXIMiller Fl4ii-jill1
jl 2X4 (ID) PT R,0011.10181 I
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28 GA , GALL/a, x 0%TSLFpllK-l�A:Tl/
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;!X�- P.Al. Z?16 2x6 ZA6
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fir 4gG' AS IM.14,10 L
Wl�IJIA Al" SKID AND AN EXTRA IKOI(')' I A L94 R V1.01
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AEC' !!no 84rwi-4' Cocles: 4w#,4
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... ........ .... . . ......... ...... .......... .............. s:
Allowanve #
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............ ..... . ........ ....... . ..... ---- - -- - -------------- ------
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f8iff, STRYCIURE HAS BEEN DESIGNED 114 ACCORDANCE WIliIINTHE 700 1FI-f)U1,'JA DOG.
2009 SUPPLEMENT ANO ASCE 7 FOR 146 MPH Ve 0 VELOC .I.
SECOND
EXPOSURE 8 FOR PARTIALLY ENCLOSED BUILDINGS.
2. ALL MATERIALS AND LABOR SHALL BE IN ACCORDANCE VvIrH TI-LI: AROVC. COUF. rui�',
ALL OTHER APPLICAULE CODES-
3. RUIMC CLASSiFIED AS RESIDENTIAL LAWN STORAGEAIGHT COMMERCIA1 'STORAGE.51.) 1 25 PSF FLOOR LOAD. NOT FOR HABITATION.
WR:TT E N DIMENSIONS SHALL TAKE PRECEDENCE OVER SCALED DIMENSIONS.
OUTSIDE OVERALL DIMENSIONS CAN VARY BETWEEN QM1-!*S Ab SHOtj.N. 8UI* MVN1.ULJ-,'
7,,pA.Cjr4G SHALL NOT EXCEED LIMITS AS INDICATED.
5. At!. LUMBER TO 1,1E #7 5YPV.g
1. ALI' "VC`DQVill HIN 6- OF GRADE OR It CRNIACT WIIII MASO.Hy 'PiAL-1. Hi fFil:Alib
TO .411 RETENTION (ACTOR IN ACCOR ,?4 E WITH AWPA Ul.
— !RUS!*. "DESiGNE0 'To SUPPORT D.L. 4- L.L. = 35 PSF
9. ALL ALUMINUM SIDING/R00FIRG TO BE 3004 ALLOY TO Asrm [3-209,
32.000 MINIMUM YIELD STRENGTH.
10. USE M8 X 3/4" TYPE A SHEET METAL SCREW FOR AL.L C,11NECTIONS BETWEEN
WASHER
f_
SIDING AND FRqE. US ij 2 AALUIA.. EI.ACX NEOPRENE
WASHER ATYIAICHED ON CONNEC IONS "LLN HUU� AN ;rR ME.
SPACING ROOF/SIDING
S F LL":
FiOOF SIDING PERIPIHERAL MEMBERA 2 i/2" OC
ROD PISIDING IN-fERIO
SIDIV - !2 Oc BOTYAMEOPERMUR.DC
11. DOOR SHALL BE I" X 1' STEEL TUBE FRAME WITH AN ALUMINUM
PANEL INSERT. ALUMINUM TRIM AND ALUj]hUJj � PlAr 14114GE ATTACHED WIII-i
ALUMINUM RIVETS. DOOR AV, 4.,'OPTIONAL .DOORS INCLUDE.
DOLIFILE ALUMINUM DOORS 4G, EHING STFE1, DOORS. TYPE.
SIZE, QUANTITY AND LbcnoN MAY VARY.'
ROBIN'S DCA APPROVEQ SYSTEMS
PACKAGE GOVERNS THE STRUCTURAL
CONTRUCTION OF THIS BUILDING
,;ate e-q
AfInt"m-ft R. —Le— -L
Nim ItIIIII, 1410141111p FIIIIII., Cx4im1mr Morids CertmIcatt: 11
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.. ............... .. . .. ....... .. ...... ....
2. ALL WINS SHALL BE lFam SOLID COP (FRTiVT)i GROUND. WIRtj-j r 'Iy -1
PROI C.Ek, T 0
PCR N. EC -t F UPF L5 A INNS TYPE MAY VARY.
ALLIMiNUm 'Jt4NOOI�YS ON M
. FYPESIZE 0U4N11Ir ANP LOCATI Ay y f? Y. A
OPTIONAL EXTERIOR WALL COVERINGS J�C,[,.UDE CORRUGATED ALUMINUM
L5
WITij ENERGY SUCE 9ACK01 sibiNG
MESA&UMINUM 4" LAP AIUMI%1�1. 6 8 PI T-III SIQ)NG VINYL FI IE c Mpg PANEL & ST STUCCO ON
.4
aF
568'F OENSE�SS GOLD-,RbOF COVEMNGS INCLUDE ALUMINUM OR SHINGLE
R 0 OVER a PLYWOOD WITH
tt
- 2 LAYERS OF 15 LEI. FELT.
z-7
15. USE 1/16' X 1 31411 16 rJA. STAPLE FOR AL;- n(illfNECTtONS BETWEEN WOOD;i
-
SIGIN(i)`fROCIF AND RAMS.
F-I.Q043ING SLIRFACF NAII 'eli(il 3' NAit-
-LO SPACED 6- OC
0 Of' FIELD.
rPUNOATION FOOTING AND ANCHORING OF UfjiT WILL LE 'IHE 0W?4;E:R'S
RESPON I Y 1-0 ,HECffWITOCAODE AUlHORIIY 10VERIFY SpErl71CREQUIR MENTS AFFE TIN HE INSTALLATION
SETUP AND UTILITY
CONNECTIONS TO THIS BUILDR49, THE PURCHASER ASSUMES ALL
Q
I
RESPONSIBILITY FOR CQMSTRUCTURE.IE TH LOCAL.
REQUIREMENTS FOR THIS COUNTY OR MUNICIPAL CODE
I -A
6A AIDI
APPROIIED?;
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A !1.*,1 PSI'
A 50 -SI-
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PSF noons
F -F.A. t 4 WINDOWS
G . T,+IS &J1L;IJ4G 15 NO) DESIGNEE)
FOR PI-ACFMENT ON YHE UPPER
Or A Pm-t OR CSCARPm----Nr CEI&FG
ROWN Dull-OrRs, ttjkl.
pa ox '117
SUBURBAN
FLORIDIAN
PINEYWOOO
STUCCO
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SUB U B ... q: NONE Eo�
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RAFTER SCHEDULE: l� DC7&2U2ISLE Mk'r0 PAN-UfiMAX. 144•,
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TIE DOWN ANCHOR: Ula" Y, 30' TWIN 4' HELIX (*30DHC2) OR
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