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Home My WebLink AboutSUBMITTED PAPERSDate: Fee One: Recei t# Permit # FLQ R I D FA Planning & Development Services Building & Code Regulations Division 2300 Virginia Ave. Fort Pierce, FL 34982 (772)462-1553 SCANNED BY St. Lucie County. SPECIALTY PERMIT APPLICATION ❑ Electrical B" Plumbing ❑ HVAC ❑ Fence ❑ Shed ❑ Demolition ❑ Gas ❑ Siding Seepage 2 for instructions and a Idditional paperwoork required for specialty permits 1. Location/Site Address: 5 ( 1 3 l�J (r-- Plod, Of Pte,Y CC- � � � �� L 2. Parcel ID Number: 3 4o2- -- coca ooY3- vou- X Office flse Only Section Township Range Map Page Zoning Land Use Initials 3. Complete Description of Project or Work: C6A11 l ��IL2a Ct !I LAT-f_� 4. Owners Information kr� 5. Contractors Information Name: I ' O &I V Address: 511 3 V�v._/ 3J i R State: City: i L(I� FL Reg/Cert #: County Cert#: Business Name: Zip: 3 I Z- Phone: 71 �--33 %'"'Phone: 6. Value of Construction: $ 'yb OWNER'S AFFIDAVIT: 1 certify that all of the information contained in this application is correct and that all work will be done in compl' ce.with all applicable laws regulating onstruction �'TA m L 0« C ,J OA (�_ n2& PRINT OWNER OR CONTRACTOR NAME SiMATILUEdE OWNER OR CONTRACTOR STATE OF FLORIDA, COUNTY OF ("�, ACKNOWLEDGED BEFORE ME THIS DAY OF 20 BY �/"' / �yv ' " WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED �y TIFICATION. �.. 1,itr sea DAWN MILONE SI OF NOTARY TYPE OR PRINT NAME OF NOTARY ;.: .: MY COMMISSION # DO 852587 EXPIRES: March 22, 2013 COMMISSION NUMBER A{;h`Bonded Thru Notary Public Underwriters 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 LECORD A NOTICE OF COMMENCEMENT MA :SULT IN YOUR PAYING TWICE FOR WROVEmr,NTS TO YOUR PROPERTY. IF YOU INTEND .� OBTAIN 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 ❑ F1VAC 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. 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 applicable 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 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 liable for 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 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 Zo 'ng Departm t t.Q the Florida St to Department of Professional Regulation. Signed and acknowledged on this day of of 20 L aa- Owne I er Signature STATE OF FLORIDA - COUNTY OF The fore 'ns me s o by pro ced fore me this %� day of , 20_//, who is personally known to me, or who has as identification. Sig—nATUre of Notary Type or Print Name of Notary Title: Notary Public Commission Number i AWN MIIONE -*: MY COMMISSION # DD 852587 EXPIRES: March 22, 2013 Bonded Thru Notary public Underwriters �. Lucie County - PCIS '-10-2011 11:29.18 11103/4089 TTER, JAYNE 13 BUCHANAN DR RT PIERCE 34982 )unt Tendered: 470.00 cunt Paid: 470.00 nse Due: 0.00 nk You ID: GESSNERJ COMM _ RES M/F 770 I 177 i NAME � mil L4 � � ACCT. # 4) SERVICE ADDRESS SUBDIVISION LOT BLOCK BILLING ADDRESS PHONE # / . t MOVE IN/CLOSING DATE this application hereby request and authorizes the Utility to render water and/or sewage disposal ervices to the premises described above in accordance with the Utilities present or future rates, ules and regulations, which by reference are made a part of this contract. Applicant agrees to pay he Utility promptly for such services in accordance with the established rules and regulations. :USTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE. SOCIAL SEC/ FED ID SPOUSE SOCIAL SEC, !! OFFICE USE ONLYl DATE RECEIVED x ' `' t CASH CHK # 1 1 ! 7 RECEIVED BY Property Appraiser - St.Lucie r-rtnty, FL Page 1 of 1 r PROPERTY RECORD CARD .Kenneth 'Potter Recu- 1 1 of <<Prev Next» Spec.Assmnt Taxes Exemptions Permits Home P•in Property Identification Site Address: 5113 Buchanan Dr Sec/Town/Range: 02 :36S :40E Map ID: 34/02S Zoning: RS-3 Ownership and Mailing Owner Kenneth Potter Jayme C Potter Address 5113 Buchanan Dr Fort Pierce FL 34982 Sales Information Date Price 3/19/2003 174900 00 1/14/1992 25500 00 1/1/1984 19000 00 10/1/1983 11700 00 ,� �tyCIE CO ParcellD: 3402-602-0023-000-8 G2 Account #. 36479 �e Land Use SF Res City/Cnty. St Lucie County '•' Legal Description INDIAN RIVER ESTATES -UNIT 1- BLK1 LOTS 23 AND 24 (MAP 34/02S) (OR 1677-2777) Assessment 2010 Final Total Land and BfAilding Jeed Book/Page 2010 Final 104000 Land Value 29700 Ace, < 0.91 WD 1677 / 2777 Assessed 104000 Building Value 74300 WD 0772 / 0898 Ag.Credit 0 Finished Area 2004 SgFt CV 0422 / 0670 Exempt 50000 CV 0415 / 1979 Taxable 54000 Taxes. 1326.76 BUILDING INFORMATION Exterior Features a View. RoofCover TN - Metal RoofStruct GA - Gable ExtType. HC- - HC- YearBlt. 1992 Frame: Grade: C- - C- EffYrBlt: 1992 PrimeWall WS - Wood/Sheath StoryHght. 0010 - 1 Story No Units 1 SecWall Interior Features BedRooms: 3 Electric: MX - MAXIMUM Pr nlntWall DW - Drywall FullBath: 2 HeatType FHA - FrcdHotAir AvgHt/FI 1/2Bath: 0 HeatFuel ELEC - Electric Prm.Flors CU - Carpet %A/C: 100 %Heated 100 %Sprinkled 0 Special Features and 'Y „rd Iten, Land Information Type T S !r, is Qual Cond. YrBlt No. Land Use T, i DWC - Driv-Concret Y 1 2100 AV AV 1992 1 0100-SF Res BI -Front Ft 132 300 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=340260200230008 2/ 10/2011