The URL can be used to link to this page

Home My WebLink AboutSUBMITTED PAPERSUNTYO D A Planning & Development Services Building & Code Regulations Division 2300 Virginia Ave. Fort Pierce, FL 34982 (772)462-1553 SCANNED S}f. "JCl e COont , SPECIALTY PERMIT APPLICATION ❑ Electrical ❑ Plumbing PHVAC ❑ Fence ❑ Shed ❑ Demolition ❑ Gas ❑ Siding See page 2 for instructions and additional paperwork required for specialty permits 1. Location/Site Address: // // - , 2. Parcel ID Number: 3 7 I J , 4,- n 00Li 1.-0a4-? " 0 611,''Jc- U_e Only Section Township Range Map Pa g Zoning an Use Initials rp a 6 3 3. Complete Description of Project or Work: 4. Owners nformation 5. Contractors Information Name: `� Q elX-,7Sp , FL Reg/Cert #: Address: County Cert#: City; State: L-- Business Name: Zip: Phone: 5 001-X) Phone: 6. Value of Construction: S '7 ; P-r, Fax: OWNERS AFFIDAVIT: I certify that all of the information cont aine in this application is correct and that all work will be done in com liance with all applicable laws regulat' construction and zoning. -IFJ t RINT OWNER OR CONTRACTOR NAME ATURE OF OWNER OR CONTRAICTOR STATE OF FLORIDA, COUNTY OF � & (��— n p / / A� ACKNOWLEDGED BEFORE ME THIS �� DAY OF , 20�, BY [ WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PROICED t-1 u v AS tUENTIFICATION. *1"" DAWN MILONE ISSION # Db 852587 SIGNATURE OF NOTARY TYPE OR PRINT NAME OF NOTARY •• Bonded March U p Notary Ief3 COMMISSION NUMBER NOTICE TO OWNER: 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. EXEMPT: A/C -HEAT REPLACEMENT WITH CONTRACT UNDER $7500.00 Revised 04/26/2010 NOTICE TO OWNER: FAIL UR CORD A NOTICE OF COMMENCEMENT NftULT 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. J - Planning & Development Services Department ® Building & Code Regulations o 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 appl' le 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 hokttvt 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 for tbe 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 relatd ,medical cost, which could include loss of wages during recovery from their injury. Initial 01 I 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 1=1r rida State Department of Professional:er/BuiSidger on. ined and acknowledged on this of 20 Z� Signature STATE OF FLO COUNTY OF The for ing i strument as ac ledl by r ire ced + of Notary Title: Notary Public SLCPDSD Revised 07/22/2010 bef a me this � day of , 20 1 / , ' I`l�✓ho is personally known U to me, or who has as identification. DAWN MILONE W. PYk MY COMMI8SI0N # b0 s52587 EXpIRM Msroh 22, 2018 Type or in Name of Notary �� 0onded tnru �Fuie Y nuoilr"#gm�to`a Commission Number Property Appraiser - St.Lucie County, FL Page 1 of 1 PROPERTY RECORD CARD Deborah S Kinsella JR) Record: 1 of 1 —Prev Next» Spec.Assmnt Taxes Exemptions Permits Home Print Property Identification —_1 Site Address: 626 Beach Ave ParcellD: 3419-510-0096-000-0 �� „. �Clt: Sec/Town/Range: 22 :36S :40E Account*: Map ID: Land Use: SF Res Zoning: RS-4 RS-4 City/Cnty: St Lucie County Ownership and Mailing Legal Description Owner: Deborah S Kinsella JR) RIVER PARK -UNIT 2- BLK 12 LOT 24(MAP 34/22N) (OR 1294-1449: Address: 626 Beach Ave 3057-2606) Port St Lucie FL 34952-1372 Sales Information Assessment 2010 Final Total Land and Building Date Price Code Deed Book/Page 2010 Final: 54600 Land Value: 11700 Acres: 0.25 1/27/2009 100 0111 WD 3057 / 2606 Assessed: 54600 Building Value: 42900 4/19/2000 75000 00 WD 1294 / 1449 Ag.Credit: 0 Finished Area: 1920 SgFt 9/11/1997 100 01 QC 1145 / 2254 Exempt: 29600 5/19/1989 63000 00 WD 0637 / 2091 Taxable: 25000 10/1/1977 0 01 CV 0275 / 2935 Taxes: 557.23 BUILDING INFORMATION Exterior Features View: RoofCover: SD - Dim Shingle RoofStruct: HP - Hip ExtType: HD+ - HD+ YearBlt: 1972 Frame: Grade: D+ - D+ EffYrBlt: 1972 PrimeWall: BS - CB Stucco StoryHght: 0010 - 1 Story No.Units: 1 SecWall: Interior Features BedRooms: 3 Electric: MX - MAXIMUM PrmintWall: PF - PF FullBath: 2 HeatType: FHA - FrcdHotAir AvgHUFI: 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 3CHT - 3CHT S 1 1 AV AV 1977 1 0100-SF Res 215 -Front Ft 110 SDSF - SITE DEV S-F Y 1 1 AV AV 2001 Depth 100 THIS INFORMATION IS BELIEVED TO BE CORRECT AT THIS TIME BUT IT IS SUBJECT TO CHANGE AND IS NOT WARRANTED. 3� (' boos{ http://www.paslc.org/prc.asp?prclid=341951000960000 8/5/2011