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Home My WebLink AboutSUBMITTED PAPERS• %. Date: Fec Due: ()U Recei t# UFO I v I Permit # co-�-J 11 St. Lucie County Building & Zoning *< 2300 Virginia Avenue Ft. Pierce, FL 34982-5652 lsC �OR1 P Tel. 561-462-1553 ' SPECIALTY PERMIT APPLICATION /y ❑ Electrical Plumbing ❑ H(VAC ❑ Fence ❑ Shed ❑ Demolition ❑ Gas ❑ Siding Seepage 2 for instructions and additional paperwork required for specialty permits 1. Location/Site Address: , 2. Parcel ID Number: 3410a — &0 / " 0130 '006 " Office Use Section Township I Range I Map Page Zoning I Land Use In' 'al Only 3 u 4. Owne s Information A ��' �C9 Jt'Gt "'�a^' 5. Contractors Information Name: - mrw— 1.�jLt)lV�6i.�'1 FL Reg/Cert #: Address: &log 5 lIt" a,/e. 'th County Cert#: City: CT PW CL State: R Business Name: Zip: 3��j ��— (J%t 6 i Z-%q- Phone �-''� Fax 6. Value of Construction: S 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 regulating construction and zoning. tea_. �• J PRINT QUALIFIERS/OWNERS NAME, SIGNATURE Or QUALIFIPR/OWNCR STATE OF FLORIDA, COUNTY OF �j s y�, V C-1 C�9 ACKNOWLEDGED HFORE ME TI IIS Q� DAY OF 20 )I, I?Y' u hn Q f c Li(J(()(KgVf i0 IS PERSONALLY KNOWN TO MR OR WHO HAS PRODUCED n Aq-7i)i3 f'IFICATION. ')au MA LX W n M 11 GNATURE Or NOTAI rY — •I'YPI: R PRINT NAMis Oj/� I' DAWN MILONE TITLE: NOTARY PUBLIC COMMISSION NUMBER 5C' � = myC.OMMISSION#DD852587 EXPIRES: March 22 2013 Bonded Thru Not Public Underwriters St. Lucic County Specialty Permit Application rcv. 8/25/05 dmfi ST. LUCIE COUNTY UTILITIES - P.O. BOX 728. FT. PIERCE. FL 34982 St. Lucie Count - PCIS 07-20-2011 �1:00:06 11720 5175 61109ASfLVERNOAK DR FLR34982RCE Amount Tendered: 470.00 Amount Paid: 470.00 Change Due: 0.00 Thank You User ID: WARDD LATERAL $ Y i� TOTAL L. I l r A NAME ACCT. # Jycw - SERVICE ADDRESS SUBDIVISION'!., LOT ! BLOCK /� h BILLING ADDRESS PHONE # / L S 7 / , MOVE IN/CLOSING DATE 0 This application hereby request and authorizes the Utility to render water and/or sewage disposal services to the premises described above in accordance with the Utilities present or future rates, rules and regulations, which by reference are made a part of this contract. Applicant agrees to pay the Utility promptly for such services in accordance with the established rules and regulations. CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE. CUSTOMER r -_ _ .1 SOCIAL SEC/ SIGNATURE t��- %� �_. o FED ID _ �( c-- �_ .� f (�. 2 L_ l l NAME OF SPOUSE C. i ,+. SPOUSE SOCIAL SEC. DATE RECEIVED r' r 6 CASH OFFICE USECHK #Y ' �(P L RECEIVED BY. Planning & Development Services Department �\-V Building & Code Regulations L C L, L L, Z4 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 applicabl 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 hq>4qAieet the minimum code. InitialZP 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 bee licensed in this jurisdiction. If for some reason they do not possess a license, I may be responsible and 1 A� 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 relate m dical 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 770 of 20 Owner/ gnature STATE OF FLORI COUNTY OF tA,1(, (� The fore oing instrument w " cknowled by FAL produced L before me thi();.--) day of , 20 , A, who is personally known to me, or who has as identification. 1 ype or rant Name or Notary Commission Number Property Appraiser - St.Lucie County, FL Page 1 of 1 PROPERTY RECORD CARD Sumner Bowman Record: 1 of 1 —Prev Next» Spec.Assmnt Taxes Exemptions Permits Home Print Property Identification Site Address: 6109 SILVER OAK LN ParcellD: 3402-607-0130-000-6 4� Sec/Town/Range : 11 :36S :40E Account #: 132079 17 S Map Ig: Land Use: SF Res RS-3 Zoning: RS-3 City/Cnty: St Lucie County Ownership and Mailing Legal Description Owner: Sumner Bowman Laura Bowman INDIAN RIVER ESTATES -UNIT 06-BLK 18 LOTS 43 AND 44 (MAP Address: 6109 Silver Oak LN 34/11S) (OR 1503-475) Fort Pierce FL 34982 Sales Information Assessment 2010 Final Total Land and Building Date Price Cede Deed Book/Page 2010 Final: 171500 Land Value: 37100 Acres: 1.14 3/15/2002 21000 00 WD 1503 / 0475 Assessed: 171500 Building Value: 134400 1/1/1900 0 / Ag.Credit: 0 Finished Area: 2530 SgFt Exempt: 50000 Taxable: 121500 Taxes: 2729.69 BUILDING INFORMATION Exterior Features View: RoofCovec SD - Dim Shingle RoofStruct: HP - Hip ExtType: HB - HB YearBlt: 2006 Frame: Grade: B - B EffYrBlt: 2006 PrimeWall: BS - CB Stucco StoryHght: 0020 - 2 Story No.Units: 1 SecWall: Interior Features BedRooms: 4 Electric: MX - MAXIMUM PrmintWall: DW - Drywall FullBath: 3 HeatType: FHA - FrcdHotAir AvgHt/FI: 1/2Bath: 1 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. YrBll. No. Land Use Type Measure Depth 1 0100-SF Res BCS -Front Ft 165 300 THIS INFORMATION IS BELIEVED TO BE CORRECT AT THIS TIME BUT IT IS SUBJECT TO CHANGE AND IS NOT WARRANTED �5_3 1 http://www.paslc.org/prc.asp?prclid=340260701300006 7/20/2011