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Home My WebLink AboutSUBMITTED PAPERSDate: � �; ) I Fee Due Receipt# Permit # 11 - 60-7 3 Planning & Development Services Building & Code Regulations Division SCgNN 2300 Virginia Ave. Sj Q i' EQ Fort Pierce, FL 34982 11Cj (772)462-1553 CoUn y SPECIALTY PERMIT APPLICATION ❑ Electrical M Plumbing ❑ HVAC ❑ Fence ❑ Shed ❑ Demolition ❑ Gas ❑ Siding See page 2 for instructions and additional paperwork required for specialty permits 1. Location/Site Address: %-h 1< �C�SS ► Ci< 2. Parcel ID Number: _5*2, - (n to - 0cf 13 - &M Z- r jjic L�52 Only Section Township Range Map Page Zoning Land Use Initials 1 v'Z 13�1 �U Z a S ��' . y �`� s✓ 3. Complete Description of Project or Work: �oQv, t 1 c) L I-tU uic4tf. . 4. Owners Information �,� ! 5. Contractors Information � Name: �l( I G �l zcI,' 1 A( 4�� FL Reg/Cert #: � Address: �)no14 Cp ;\a �F—. County Cert#: City: f q),� Ptyice, State: L Business Name: Zip: �j Q 0 Phone: 10Phone: 6. Value of Construction: $ Fax: OWNERS AFFIDAVIT: I certify that all of the information contained in this application i correct and that all work will be done in compliancewithall applicable laws regulating con ction an z ning. �>.{iG Ll Zed�I1 �t�rn4 ►� PRINT OWNER OR CONTRACTOR NAME SIGNATUR F OrNER dR CONTRACTOR STATE OF FLORIDA, COUNTY OF Sf UA-C eC� ACKNOWLEDGED BEFORE ME THIS 5� DAY OF C.l u 20 l ( . BY ())A—, t a. A Ie MC .1 WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED �Ja «- 0�7` �% �� AS IDENTIFICATION. SIGNATURE OF NOTARY COMMISSION NUMBER TYPE OR PRINT NAME OF NOTARY (seal) 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: FAILURE TO RECORD A NOTICE OF COMMENCEMENT D RESULT IN YOUR PAYING TWICE FOR IM[PROVENIENTS 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 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 applicable laws, ordinances, building codes, and zoning regulations. Initial V L A I understand that the building official and inspectors are not there to design or give advice on how to meet the minimum code. Initial MLA 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 [4 LA 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 the cost of the license. Initial L .A 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 related medical 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 ackn wledged on this day of of 20 r Owner/Buil er S3 a STATE OF FLORIDA COUNTY OF 5 - LUCA 6 The foregoing instrument was acknowledged before me this 5 day of 20 I , by W ,,r, 4 1(-AkIc fn0Lv\ who is personally known to me, or who has produced Me— 3rL Li i, OL" % k' 7 13' as identification. Signature of Notary Title: Notary Public SLCPDSD Revised 07/22/2010 Type or Print Name of Notary Commission Number (Seal) Property Appraiser - St.Lucie Coi, FL Page 1 of 1 Maria L Aleman Record: 1 of 1 Property Identification Site Address. 6014 Cassia Dr Sec/Town/Range: 12 :36S :40E Map ID: 34/12S Zoning: RS-4 Ownership and Mailing Owner. Maria L Aleman Address 6014 Cassia Dr Fort Pierce FL 34982 PROPERTY RECORD CARD <<Prev Next» Spec.Assmnt Taxes Exemptions Permits Home Print , v\PE CO ParcellD: 3402-610-0473-000-2 y� L G� Account #: 38589 Land Use: SF Res City/Cnty: St Lucie County �! Legal Description INDIAN RIVER ESTATES -UNIT 9- BLK86 LOT 13 (MAP 34/12S) (OR 3059-2508) Sales Information Assessment 2010 Final Total Land and Building Date Price Code Deed Book/Page 2010 Final: 83800 Land Value: 10400 Acres: 0.23 2/6/2009 60000 0112 SP 3059 / 2508 Assessed: 83800 Building Value: 73400 10/29/2008 100 01 CT 3035 / 1271 Ag.Credit: 0 Finished Area 1864 SgFt 12/22/2006 208000 00 WD 2730 / 2449 Exempt: 6/11/2004 160000 02 WD 1992 / 0825 Taxable: 5/3/2004 01 CA 1960 / 2439 Taxes. 1741.7 4/1/1984 5800 01 CV 0429 / 2952 3/1/1981 4500 00 CV 0351 / 0453 7/1/1976 2800 01 CV 0256 / 2252 BUILDING INFORMATION Exterior Features View RoofCover: SD - Dim Shingle RoofStruct: GA - Gable ExtType HC- - HC- YearBlt. 1984 Frame Grade C- - C- EffYrBlt: 1984 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/Fl: 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 City Units Qual. Cond YrBlt No Land Use Type Measure Depth DWC - Driv-Concret Y 1 720 AV AV 1984 1 0100-SF Res 215 -Front Ft 80 125 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=340261004730002 8/5/2011