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HomeMy WebLinkAboutSUBMITTED PAPERSDate: . JJ Fee Due: C7 Recei t#. Permit # % Planning & Development Services - J J Building & Code Regulations Division 2300 Virginia Ave. S . Fort Pierce, FL 34982 Cq ENE p (772)462-1553 St' t U B SPECIALTY PERMIT APPLICATION ❑ Electrical ❑ Plumbing ❑ HVAC ❑ Fence ❑ Shed ,Demolition ❑ Gas ❑ Siding Seepage 2 for instructions and yyaddditional paperwork required foor�specialty permits � 1. Location/Site Address: % Oa) Z • �Jcs�� , �L► wQ Dom+ �'�+i►' 'r�) �!' y ��� 2. Parcel ID Number: 7 S /� S Ci a+ ood () / 0/%ice Use Only Sec ion Township Range Map Page Zoning Land Use Initials 3. Complete Description of Project or Work: 4. o Nam Address: (�� �a s 0 CO, City: State: Zip: `� S� Phone: a %S q 4 o 6. Value of Construction: $ — O— County Cert#: 7 Business Name: Phone: / Fax: 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 c structio oning. PRINT O ER OR CONTRACTOR NA SIGNAT O O R OR CONTRACTOR STATE OF FLORIDA, COUNTY OF ACKNOWLEDGED BEFORE ME THIS DAY OF WHO IS PERSONALLY KNOWN TO ME OR WHO HAS AS IDEN ICATION. m� a ZM�.. (seal) SIGNAWJYffUF-7NO KV 1p TY OR PRINT ME OF NOTARY COMMISSION NUMBER NOTICE TO OWNER: EXEMPT CST h 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. A/C -HEAT REPLACEMENT WITH CONTRACT UNDER $7500.00 Revised 04/26/2010 NOTICE TO OWNER: FAILURE TO RECORD A NOTICI% OF COMMENCEMENT MA, . -SULT 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 $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 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. ❑ 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, 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: 00 PM without special arrangements and additional fee paid. Upon issuance of this permit, required inspections can be scheduled by calling (772) 462-1261. Property Appraiser - St.Lucie C ity, FL Page I of 1 PROPERTY RECORD CARD Jay M Horst Record: 1 of 1 <<Prev Next» Spec.Assmnt Taxes Exemptions Permits Home Print Property Identification V ICIE CO Site Address: 10725 S OCEAN DR ParcellD: Sec/Town/Range 11 :37S :41 E Account #: 123584 Map ID: 45/11B Land Use: Mob Homes Q� Zoning HIRD City/Cnty: St Lucie County Ownership and Mailing Legal Description Owner: Jay M Horst Claudette C Horst HOLIDAY OUT AT ST LUCIE - SEC B BLK O LOT 8 AND EQUAL Address: 10725 S Ocean Dr #462 PRO-RATA INTEREST IN COMMON ELEMENTS (OR 3247- Jensen Beach FL 34957 More... Sales Information Assessment 2010 Final Total Land and Building Date Price Code Deed Book/Page 2010 Final: 45500 Land Value: 42500 Acres: 0.05 11/3/2010 62000 0001 WD 3247 / 1253 Assessed: 45500 Building Value: 3000 1/9/2008 87500 00 WD 2927 / 1079 Ag.Credit: 0 Finished Are 6/21/2001 32500 00 WD 1405 / 2470 Exempt: 5/4/1993 34500 01 WD 0840 / 1792 Taxable: 4/18/1990 32500 00 WD 0688 / 2248 Taxes: 945.69 2/1/1980 15000 00 CV 0326 / 1559 BUILDING INFORMATION Exterior Features View: RoofCover: - RoofStruct: - ExtType: MHH - MHH YearBlt: 1982 Frame: - Grade MHTT - MHTT EffYrBlt: 1982 PrimeWall - StoryHght: 0010 - 1 Story No.Units: 1 SecWall: - Interior Features BedRooms: 0 Electric: - PrmintWall: - FullBath: 0 HeatType: - AvgHt/FI: 1/26ath 0 HeatFuel: - Prm.Flors: - %A/C 0 %Heated: 0 %Sprinkled: 0 Special Features and Yard Items Land Information Type Y/S Qty- Units Qual. Cond. YrBlt. No Land Use Type Measure Depth 1 0200-Mob Homes BI -Site 1 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=451150200780009 8/ 1 /2011 J '^ Planning &q)evelopment Services Department Building & Code Regulations a1' • 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 hue 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 appli bl aws, ordinances, building codes, and zoning regulations. Initial I understand that the building official and inspectors are not there to design or give advice on h t 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 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 1' le f r+ e 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 rel d m cal 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 Depart t to the Florida State Department of Professional Regulation. Signed and acknowledged on this day of of 20 A Own*/B1ti!lder' Signature STATE OF FLORIDA COUNTY OF ` The foiTgLoing ins ent was acknowledged before me this __L day of , 20—LL_1 b Al who is personally known to me, or who has pr d as iden fication. Gct�/ (,,,43- rgnature of o ary Type or Print VameAf Nkffryal) Title: Notar Public Commission Nma6er SLCPDSD Revised 07/22/2010 _ — r :�,. �u AUDREY B. HUMPHREY 5 , MY COMMISSION # EE 061159 �c-r• 2015 b • `*� EXPIRES: March 6, '�"' Oonded Thru Notary Public Underwriters 'i'1. T Planning & Development Services Building & Code Regulation Division 2300 Virginia Avenue Fort Pierce, FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 08/01 /2011 JAY M. HORST 10725 S OCEAN DR #462 JENSEN BEACH, FL 34957 RE: Building Permit NumbE 1108-0012 ASBESTOS NOTICE TO OWNER/BUILDER Disclosure Statement: State law requires asbestos abatement 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 asbestos abatement contractor even though you do not have a license. You must supervise the construction youself. You may move, remove or dispose of asbestos -containing materials on a residential building where you occupy the building and the building is not for sale or lease, or the building is a farm outbuilding on your property. If you sell or lease such building within 1 year after the asbestos abatement is complete, the law will presume that you intended to sell or lease the property at the time the work was done, which is a violation of this exemption. You may not hire an unlicensed person as your contractor. Your work must be done according to all local, state and federal laws and regulations which apply to asbestos abatement projects. It is your responsibility to notify the Department of Envronmental Protection of your intentions to remove asbestos. It is your responsibility to make sure that the people employed by you have licenses required by state law and by county or municipal licensing ordinances. Owner Signature & Date