HomeMy WebLinkAboutSUBMITTED PAPERSDate:
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J I Permit # / `U 10/`
Planning & Development Services
Building & Code Regulations Division SCByNEp
2300 Virginia Ave. St. Lucie
Fort Pierce, FL 34982 county
(772)462-1553
%/ SPECIALTY PERMIT APPLICATION
C/Electrical ❑ Plumbing ❑ HVAC ❑ Fence
❑ Shed ❑ Demolition ❑ Gas ❑ Siding
Seepage 2 for Instructions and additional paperwork required for specialty permits
1. Location/Site Address: (o00 R LT �''r • �.` �� `-
2. Parcel ID Number: 13D.;� `L iO- O1\O QCX-)- 1
-nl C's-
Section
Township
Raage
Map Page
Zoning
Land Use
Iddal+
only
0
3. Complete Description or Project or Work: f ���Lh ,� r r. L� a e Y V. tC.c� -ti'L U 6'r 4 U J� y
4. Owners Information ,5�.�,C(ontractors Information
Name: � c ;c:,_�. `(\i� C- � C�. w � �Q�� � 1 � V,,\FL Reg/ Cert #:
Address: 6,00 - 4o A C_-Iri C: r. County Cert#:
City: F-t . Q ,, rc e — State: V-- L Business Name:
Zip: "-� A cl 51 Phone: 11,,:� - cA iG - 17,28 Phone:
Fax:
cam_
6. Value of Construction: $
OWNER'S 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 zo '
_7
SIGNATURE OF OWNER OR CONTRACTOR
PRINT OWNER OR CONTRACTOR NAME
STATE OF FLORIDA, COUNTY OF C A
ACIIaIOWLEDG ORE ME THIS � DAY OF O�/ 20_ I i . BY �� \O—�Y� / ► G�C
WHO S PERSONALLY I WN TOME OR WHO HAS PRODUCED
ENTIFICATION. f l /� 1 P ;;� 'P''. DAWN MILONE
MY COMMISSION 852567
TYPE OR PRINT NAME OF NOTARY a EXPIRES: March 22, 2013
URE OF NOTARY -1 y". � ��' Bonded Thru Notary public Underwriters
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 TO I RD A NOTICE OF COMMENCEMENT MAY I LT IN YOUR PAYING TWICE FOR
IMPROVEMEN t o , O YOUR PROPERTY. IF YOU INTEND TO ..Y _ AIN 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.
, , F
QUNTY
St. Lucie county
Building & Zoning Department
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 ��
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 _4;�,
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 1;15
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 ingoical
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 acknowledged on this
Q$ day of T�, of 20 �. c
Owner/Builder Signature
STATE OF FLO
COUNTY OF
The I Megonnstrument was acknowledged before ;4.
day of ,20by`n M C,A CLM who inown to me, or who has
�-� uced siddeentific_ationn..
Signature of Notary Type or Print Name of Notary' ;::.; ILONE
Title: Notary Public Commission Number •: MY COMMISSION a DO 852587
EXPIRES: March 22, 2013
i; p, j„fir° Bonded ihru Notary Public Underwriters
Property Appraiser - St.Lucie County, FL
Page 1 of 1
+ %
PROPERTY RECORD CARD
Brian McLam Record: 1 of 1
<<Prev Next» Spec.Assmnt
Taxes Exemptions Permits Home Print
Property Identification
��UCIE co
Site Address: 6008 ROLAND CT
ParcellD:
1302-810-0110-000-1�<
Sec/Town/Range: 02 :34S :39E
Account #: 3966
Map ID: 13/02S
Land Use
SF Res
Zoning: RS-4
City/Cnty:
St Lucie County
Ownership and Mailing
Legal Description
Owner: Brian McLam Terri
McLam
LAKEWOOD PARK ADDITION NO 1- BLKE LOT 8 (OR 3203-1347:
Address. 6008 Roland Ct
3248-1123)
Fort Pierce FL 34951
Sales Information
Assessment 2010 Final
Total Land and Building
Date Price Code
Deed
Book/Page
2010 Final: 80400
Land Value: 11500 Acres 0.37
11/22/2010 100 0111
QC
3248 / 1123
Assessed: 80400
Building Value: 68900
5/26/2010 68000 0112
CT
3203 / 1347
Ag.Credit: 0
Finished Area: 1688 SgFt
5/6/2005 185000 00
WD
2243 / 0957
Exempt:
5/1/1980 19500 02
CV
0356 / 0721
Taxable:
Taxes' 1671,06
BUILDING INFORMATION
Exterior Features
k 5 5 3
View.
RoofCover:
SA - Asph Shingle
RoofStruct
HP - Hip
ExtType:
HC- - HC-
YearBlt:
1982
Frame:
Grade:
C- - C-
EffYrBlt:
1982
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/FI:
STD
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
YrBIt. No. Land Use
Type
Measure Depth
3CNT - 3CNT
S 1
1 AV AV
1982 1 0100-SF Res
BI -Front Ft
94.8 170.38
SDSF - SITE DEV S-F
Y 1
1 AV AV
2001
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=130281001100001 12/8/2010