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HomeMy WebLinkAboutSUBMITTED PAPERSPlanning & Development Services 9 Building &Code Regulations Division %9C COUNTY 2300 Virginia Ave. 'q^/ • R I D A- Fort Pierce, FL 34982 St ( eYNF� (772)462-1553 "Cie Co4,7 t1' SPECIALTY PERMIT APPLICATION G3 Electrical ❑ Plumbing ❑ HVAC ❑ Fence ❑ Shed ❑ Demolition ❑ Gas ❑ Siding Seepage 2 for instructions and additional paperwork required for specialty permits 1. Location/Site Address: 51 1 RV D 1 .41-po [?-t ✓ 61 tz a 12. 2. Parcel ID Number: Z Z ' 00 4 1 — d C�) (a Only Section Township Range Map Page zoning Lid I�i6ab 2 2 300 d 1 ©0 J 3. Complete Description of Project or Work: To UrJ (D &r-2 G /ZOLI NI 70 �6& 1::'1eoo4 0IJ!�KRfYAP n i» G/Lle1 D r! S612Vi TA 7 =R- &-G sic D1s S co�✓� ��i 4. Owners Information 5. Contractors informatign Na me: 2�A,'A&(� 14,/L0/� �%Gii'FLReg/Cert ( Address: /��/� RI ✓02 40R County Cert#: D WN tre• Sig �� s • City: � �i �/,�2C�1 State: in - Business Name: zip:- g g 2 Phone: 772-l -94 4%one3'2-3 )g_ O / a : � ` a 6. Value of Construction: $ /I 2 �� OWNERS AFFIDAVIT: I certify that all of the information contained in this app atio s com liance with all applicable laws regulating cans tion d z PRINT OWNER OR CONTRACTOR N SIG OF OWNER OR STATE OF FLORIDA, COUNTY OF Q ACKNOWLEDGED BEFORE ME THIS ��DAY OF 20 �0 , BY O O WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED that all work will be done in Z-1- -- - - - RT-FLACTOR n X n C Zcng ^ a�v_'m AS IDENTIFICATION. o i SIG TURF OF NO Y TA R PRINT N OF NOTARY 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. W NOTICE TO OWNER: FAILURE TO RR tD A NOTICE OF COMMENCEMENT MAY I - LT IN YOUR PAYING TWICE FOR IMPROVEMENI ) YObR PROPERTY. IF YOU INTEND TO AIN 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 Indicate the street address or general location of property where the building activity is taking place. 2. Parcel ID Number Indicate the tax identification number of the property where the building activity is taking place. 3. Description of Project or Work Activity Fully describe the activity to take place. 4. Owner Information Indicate the name and address of the owner of the property on which activity is taking place. 5. Contractor Information Indicate the State of Florida registration number (if applicable), St. Lucie County contractor license . number and the name of the business doing the work. 6. Value of Constriction 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. O ® kl= Planning & Development -Services Department i, I Building & Code Regulations Division ` - 2300 Virginia Ave Fort Pierce, FL 34982 772-462-1553 Owner Builder Affidavit — Electrical Contracting DISCLOSURE STATEMENT F.S. 489.503 (6) EXEMPTIONS State law requires electrical contracting to be done by licensed electrical 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 electrical contractor even though you do not have a license. You may install electrical wiring for a farm outbuilding or a single-family or duplex residence. You may install electrical wiring in a commercial building the aggregate construction costs of which are under $75,000. The home or building must be for your own use and occupancy. It may not be built for sale or lease. If you sell or lease more than one building you have wired yourself within I year after the construction is complete, the law will presume that you built it for sale or lease, which is a violation of this exemption. You may not hire an unlicensed person as your electrical contractor. Your construction shall be done according to building codes and zoning regulations. 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. Failure to do so may result in a liability for you! To qualify for this exemption under this subsection, an owner must personally appear and sign the building permit application. 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 exemptigh shall be reported by the Community Development Director to the Florida State Depeft9nent of ofqgsi al Regulation. Signed and acknowledged on this a`Z 2 day of D0CV w% 13 R-1 q� C�WNER/BUILDER SIGNATURE STATE OF FLORIDA COUNTY OFF The foregoing instrument was acknowledged before me this Ge.�7 day of /e/2p / 42 by ej9jVN/4711N , who is personally known to me or Title:_ Notary Public Commission Number SLCPDSD Revised 7/23/2010 St. Lucie County Owner Builder Affidavit -Electrical Contracting as identification. (Seal) W Cp Rl4 OHU�fp R � EXPIRES. d b o,' Bonded ThN Nofa Qrctl r C6, U`,N L R�11 St. Lucie ---nty 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 worker ' compensation for that employee, all as prescribed by law. Your construction must comply with all applic ordinances, building codes, and zoning regulations. Initial I understand that the building official and inspectors are not there to design or give advice on trot the minimum code. Initial I understand that as an owner -builder that any contract disputes with sub -contractors and I must be d 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 require licensed in this jurisdiction. If for some reason they do not possess a license, I may be responsible and liab e cost of the license. Initial I understand that if any person that is unlicensed and uninsured gets injured on my construction e - they may be entitled to workmen's compensation. I could be held liable for all doctor, lawyer and relate al 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 tatement and tha further understand that any violation of the terms of the ownerlbuilder exemption shall ported�' t e ilding and Zoning Department to the Florida State Department of Professional RegulationYe� ag/ c�j�ed on this day of 1% ff Ct71�1$ b/r' of 20 L. 1 � // O'wner/Builder Signature STATE OF FLORIDA Ike/ COUNTY OF The foregping ins tr ment Was ackr{owledged before me thisd_�Lday of , 20109 by _ who is personally known to me, or who has produced as identification. rid/' . J,lu- Signature of 66tary a or Print Vamek Notary (Seal Title: Notary Public Commission Num er AJDHEy D. HUM'pH lLcy iki, — .. Onv4 coc:.l IRES: Mach 6, 2011 Property Appraiser - St.Lu-i- County, FL Ronnie S Klein Record: 1 of 3 Property Identification Site Address. 5803 S INDIAN RIVER DR SeciTown/Range 01:36S:40E Map ID. 34/01S Zoning AR-1 Ownership and Mailing Page 1 of 1 PROPERTY RECORD CARD «Prey Next» Spec.Assmnt Taxes Exemptions Permits Home Print Parcel I D: 3401-423-0001-000-6 CIE co � �2 Account #: 36429 Land Use: SF Res CitylCnty St Lucie County Owner: Ronnie S Klein Brigitte K Klein Address P O Box 3157 High Springs FL 32655 Sales Information Date Price Code Deed 3/10/2010 340000 0001 WD 8/30/1994 100 01 QC Exterior Features Legal Description 1 36 40 FROM INT OF N LI OF GOV LOT 2 AND E LI OF FEC RR RUN SELY 1068.33 FT FOR POB,TH ELY TO IND R More... Assessment 2010 Final Total Land and Building Book/Page 2010 Final 284300 Land Value 187700 Acres 4.13 3181 / 0710 Assessed: 232440 Building Value 96600 0918 / 2452 Ag.Credit 0 Finished Area 2892 SgFt Exempt: 50000 Taxable: 182440 Taxes: 3996.28 BUILDING INFORMATION View: RoofCover. CS - Conc Shingle RoofStruct HP - Hip ExtType: HC+ - HC+ YearBlt: 1949 Frame: Grade: C+ - C+ EffYrBlt: 1977 PrimeWall: BP - Conc Block StoryHght: 0010 - 1 Story No.Units: 1 SecWall: Interior Features BedRooms: 3 Electric: MX - MAXIMUM PrmintWall: DW - Drywall FullBath 2 HeatType: FHA - FrcdHotAir AvgHUFI. 1/26ath. 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 vteas.,:e Dep! , FEN4 - CHAINLINK 4' Y 1 126 AV AV 1977 1 0100-SF Res 525 -Acres 0.89 2 0100-SF Res 210 -Front Ft 153.8 3 0100-SF Res N -Acres 1.73 More... 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=340142300010006 12/22/2010