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Home My WebLink AboutSUBMITTED PAPERSDute: Fee Due: Permit # 'ICOUNTY Planning & Development Services Building & Code Regulations Division 2300 Virginia Ave. Fort Pierce, FL 34982 (772)462-1553 SPECIALTY PERMIT APPLICATION Electrical ❑ Plumbin ❑ HVAC olence SCANNEC; ❑ gBy ❑ Shed ❑ Demolition ❑ Gas ❑ Siding St' LUG e Cola ntv Seepage 2 for Instructions and additional paperwork required for specialty permits Y v 0 npne / .5�` GvGiL �t�4- 1. Location/Site Address: ! ''4 !Ic�o� 2. Parcel ID Number: Only Section Township Raege Map Page Zoaiug Lod Use IaitiaLs 3. Complete Description of Project or Work: re- X �'`� Lr w, 7'v Inf tion r`C P s'T L I A/ r 5. contractors Information l— e,tiGi` 1 A-f Tr,�� .7 LF- 4.Owners orma A) FL Reg/Cert #: Name: ��.�, 9 S1iF�1l✓LA —� Address: ?/ L/ h/r $� County Cert#: city: J S T L vG /I= State: �. _ Business Name: Zip: Phone: 272) �� " Phone: Fax: 6. Value of Construction: S 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 construction and zoning. PRINT OWNER OR CONTRACTORAAW I / % SIGNATURE OF OWNER OR CONTR/�fOR a STATE OF FLORIDA. COUNTY OF ACKNOWLEDGED BEFORE ME THIS DAY OF �, BY IJE� & + t ��- I� g m < y WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED -f I i0 o M CI AS IDENTIFICATION. m m = Ay SIG TURF OF NO Y TYPE OR PRINT N F NOTARY o �Q a 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 $5,000. NOTICE TO OWNER: FAILURE "I :CORD A NOTICE OF COMMENCEMENT ME ESULT IN YOUR PAYING TWICE FOR MROVEM..x L.. S TO YOUR PROPERTY. IF YOU INTEND )BTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. EXEMPT: A/C -HEAT REPLACEMENT WrM 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. CLIENT NARRATIVE VEEK ENDING PAGE � a FILE ,J c7 S ' e 7 S T. 4 Lxc ,. -` c , 3 s a A 2 Z, �j r j per 4- 64r uoj v e /o l SL 0 THE FULL SIGNATURE AN[ ...'LE OF EACH NURSE MUST BE WRITTE TER EACH SHIFT'S DOCUMENTA]ION. ,,,,, , oo cr COUNTY F L O R] D A St. Lucie County Building & Zoning Department 2300 Virginia Avenue Fort Pierce, Florida 34982 (772)462-1553 OWNERBUILDER 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 applica 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 how to eet 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 f r the 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 related weical 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 ownerlbuilder exemption shall be reported by the Building and Zgiing Departme to he Florida State Department of Professional Regulation. Signed and acknowledged on this _,T day of of 20 _t4. STATE OF FLORIDA COUNTY OF Z�e� 31gnawre Vl i-4Ulitry Title: Notary Public Owner/Builder Signature Type or Print Name of Notary Commission Number , 20 me, or who has (Seal) tp://documents.sttucieco.gov/weblink7/ElectronicFile.aspx?docid=143323£tdbid=0 - Microsoft Int... ., Edit Go To Favorites Help :orites - e re Scanned Aerial and ... w e -. m, - Page - Safety • Tools - r# - :tp:; ldocuments.stlucieco.go\5 veeblink7iEle... g :lave a CC-, _. \ Select .� Sign - �( Picture -ask; Y� Mortgegm s -. • i 1� Subscribed and bwern to _ __ .. Koto�y Public. Sty(}m o{ t--lor�da of t"o�•y� (P iL O a 9 ( G P P e 37.20 x 26.00 in < N cuja-.: rrs�psct ios of tR•a. fora qoi nayc.+5 .on, tSR 1. L mRa and 1^nse menRs e> sl.o.un hereon stie11N r .. .isr4 }oe SR. Luc'.s CLivsr t_ond o ny, s�antn n �, it nucR. S{r,ze to and"aos cocas+>,ors and otis-�q mn�c to ba. 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RS-4 Ownership and Mailinc Owner V411�sa StiegeYMPPM I Address. �t4 NE Camino 5t'u� �ort St Lu4952-1442 PROPERTY RECORD CARD «Prey Next» Spec.Assmnt Taxes Exemptions Penruts Hunie Account # 42251 Land Use SF Res City/Cnty St Lucie County Legal Description RIVER PARK -UNIT 3- BLK 27 LOT 7 (MAP 34/22S) (OR 1398-2835) Sales Information Assessment 2010 Final Total Land and Building Date Price Code Ueer: Book/Page 2010 Final 33400 Land Value: 9900 Acres 0.22 5/31/2001 61000 00 WD 1398 / 2835 Assessed: 33400 Building Value. 23500 6/4/1999 44600 00 WD 1229 / 2358 Ag.Credit 0 Finished Area 1088 SgFt Exempt: 25000 Taxable 8400 Taxes 174.58 BUILDING INFORMATION U M•...�. arty✓• Qa, � Exterior Features View: RoofCover SA - Asph Shingle RoofStruc GA - Gable ExtType: HD+ - HD+ YearBlt. 1963 Frame Grade: D+ - D+ EffYrBlt. 1963 PnmeWall BS - CB Stucco StoryHght 0010 - 1 Story No.Units 1 SecWall Interior Features BedRooms: 2 Electric: MX - MAXIMUM PrmintWall PF - PF FullBath 1 HeatType FHA - FrcdHotAir AvgHt/FI: STD 1/2Bath 1 HeatFuel: ELEC - Electric Prm.Flors TZ - Terrazo %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 T,, 1 0100-SF Res 215 -Front Ft 75 130 THIS INFORMATION IS BELIEVED TO BE CORRECT AT THIS TIME BUT IT IS SUBJECT TO CHANGE AND IS NOT WARRANTED littp://www.paslc.org/prc.asp?prclld=341951501830002 2/8/201 1