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
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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