The URL can be used to link to this page

Home My WebLink AboutSUBMITTED PAPERSDate: Fee Due: Permit # " 11 CC+UNTY 4 F L O R I D A ❑ Electrical ❑ Shed Planning & Development Services Building & Code Regulations Division 2300 Virginia Ave. Fort Pierce, FL 34982 (772)462-1553 SPECIALTY PERMIT APPLICATION ❑ Plumbing ❑ HVAC ❑ Fence ❑ Demolition ❑ Gas ❑ Siding Seepage 2 for instructions and additional paperwork required for specialty permits 1. Location/Site Address: L. 2. Parcel ID Number: ` �+' oot sq st 411e y�Fa cre coul?t y office U_� Only Section Township Range Map Fag - 3. Complete Description of Project or Work: 4. Owners Informs tion 5. Contractors Information Name: Address:` ti City: �+ �—F�V`, State: Zip: r .� (� Phone: 7 . 6. Value of Construction: $ FL Reg/Cert #: oW lyc�e- County Cert#: Business Name: Phone: aa• OWNER'S AFFIDAVIT: I certify that all of the information contained in this application is correct ana tnai an Worx WILL uc u g UL compliance with all applicable laws regu t' construeti zoning. R, -r��t+ Prt� Son 2 d z PRINT OWNER OR CONTRACTOR N OF O C RACTOR s rn p 9 STATE OF FLORIDA, COUNTY OF o w' � � o ACKNOWLEDGED BEFORE ME THIS �_ DAY OF WHO IS PERSONALLY KNOWN TO ME OR WHO U OF NOT COMMISSION NUMBER � 20_1 , BY ,R PRINT NAME OF NOTARY 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 S5,000. NOTICE TO OWNER: FAILURE I 'CORD A NOTICE OF CONMIENCEMENT M. ;ESULT IN YOUR PAYING TWICE FOR WROVEN S TO YOUR PROPERTY. IF YOU INTEND OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF CoWffiNCEMENT. 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. • 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 orkers' compensation for that employee, all as prescribed by law. Your construction must comply with all appli a 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 ho 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 li fo the cost of the license. Initial I understand that if any person that is unlicensed and uninsured gets injured on my constructs project - they may be entitled to workmen's compensation. I could be held liable for all doctor, lawyer and relat cal 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 Zonitsg Depart e t to the Florida State Department of Professional Re lation, Signed and acknowledged on this T day of of 20 -/-P Bui der ig ture STATE OF FLORIDA COUNTY OF' The forom strument w acknowledged bL--'efore me this day of 20 by who is personally knowVitio o me, or who has produced as identin. Signature of Not Ivype or Name of Notary (Seal) Title: Notary Pub is Commission Number AL DREYB.HUMPHREY MY COMMISSION # DD 633047 EXPIRES: March 6, 2011 of Bonded Thru Nditry Public 6"derwrters _ WAXER OMM SEWER =RES METER SZ. M/F VIRR �/ ✓) SECURITY DEP SERVICE FEE SAME DAY FEE OVERTIME FEE METER INSTALL. CFC/WATER FPUA CFC CFC/SEWER GUAR. REV. LATERAL =-j i° (/ • ��/ : TOTAL JSTOMER GNATURE� r t'��`•TEI!�c.i�fi".:.3�.IEY'"':h`t•.,�,s� ,;F•3r,,;i+ � ... - P.O. NAME ACCT. # SERVICE ADDRESS q VQ L/ Y� SUBDIVISION LOT .:.BLOCK BILLING ADDRESS #:2,0 c fig J Ll� MOVE IN/CLOSING DATE This application hereby request and authorizes the Utility to render water and/or sewage disposal services to the premises described above in accordance with the Utilities present or future rates, rules and regulations, which by reference are made a part of this contract. Applicant agrees to pay the Utility promptly for such services in accordance with the established rules and regulations. CUSTOMERS DEPOSITS ARE NON NEGOTIABLE OR TRANSFERABLE. SOCIAL SEC/ FED ID kME OF SPOUSE SPOUSE SOCIAL SEC. r fa OFFICE USE ONLY T)ATF. RFr.FTVFT) ��. ; 1 J CART4 r-"V-f 1 i RF('FivPn RVA Property Appraiser - St.Lucie ( ity, FL Page 1 of 1 PROPERTY RECORD CARD Jeffrey S Jackson Record: 1 of 1 <<Prev Next » Spec.Assmnt Taxes Exemptions Permits Home Print Property Identification Site Address: 4704 SEAGRAPE DR ParcellD: 3402-608-0062-000-1 \,o%IEcoG� Sec/Town/Range: 02 :36S :40E Account # 37188 �� < Map ID: 34/02N Land Use: SF Res Zoning. RS-4 City/Cnty St Lucie County Ownership and Mailing Legal Description Owner: Jeffrey S Jackson Cynthia J Schleif INDIAN RIVER ESTATES -UNIT 07- BLK 39 LOT 7 (MAP 34/02N) (OR Address 4704 Seagrape Dr 1995-1313) Fort Pierce FL 34982-7131 Sales Information Assessment 2010 Final Total Land and Building Date Price Code Deed Book/Page 2010 Final 47500 Land Value 10400 Acres 0.23 6/15/2004 112000 00 WD 1995 / 1313 Assessed 47500 Building Value: 37100 2/26/1998 51300 00 WD 1128 / 2656 Ag.Credit 0 Finished Area: 948 SgFt 9/1/1985 42400 00 CV 0477 / 2167 Exempt 25000 3/1/1984 43900 00 CV 0427 / 2134 Taxable: 22500 11/1/1983 6500 01 CV 0418 / 2409 Taxes 467.65 9/1/1972 2000 00 CV 0207 / 0148 BUILDING INFORMATION Exterior Features View. RoofCover SD - Dim Shingle RoofStruct: HP - Hip ExtType. HC - HC YearBlt 1984 Frame: Grade C - C EffYrBlt: 1984 PrimeWall: WS - Wood/Sheath StoryHght. 0010-1 Story No.Units: 1 SecWall: Interior Features BedRooms 2 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 Meas�,r DepIh DWC - Driv-Concret Y 1 600 AV AV 1984 1 0100-SF Res BI -Front Ft 80 125 FNW6 - WOOD FEN 6' Y 1 220 AV AV 1999 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=340260800620001 1 / 11 /201 1 Property Appraiser - St.Lucie C Ity, FL Page 1 of I PROPERTY 4,111 CARD Jeffrey S Jackson Record: 1 of 1 <<Prev Next » Spec.Assmnt Taxes Exemptions Permits Home Print Property Identification Site Address 4704 SEAGRAPE DR ParcellD 3402-608-0062-000-1 \��Vt)CIE��G2 Sec/Town/Range 02 :36S 40E Account # 37188 Map I Land Use: SF Res Zoningg RS-4 RS-4 CdylCnty St Lucie County Ownership and Mailing Legal Description Owner: Jeffrey S Jackson Cynthia J Schleif INDIAN RIVER ESTATES -UNIT 07- BLK 39 LOT 7 (MAP 34/02N) (OR Address: 4704 Seagrape Dr 1995-1313) Fort Pierce FL 34982-7131 Sales Information Assessment 2010 Final Total Land and Building Date Price C ode Deed Book/Page 2010 Final 47500 Land Value 10400 Acres 0.23 6/15/2004 112000 00 WD 1995 / 1313 Assessed. 47500 Building Value: 37100 2/26/1998 51300 00 WD 1128 / 2656 Ag.Credit 0 Finished Area 948 SgFt 9/1/1985 42400 00 CV 0477 / 2167 Exempt: 25000 3/1/1984 43900 00 CV 0427 / 2134 Taxable 22500 11/1/1983 6500 01 CV 0418 / 2409 Taxes 467.65 9/1/1972 2000 00 CV 0207 / 0148 BUILDING INFORMATION Exterior Features View RoofCover SD - Dim Shingle RoofStruct HP - Hip ExtType HC - HC YearBlt: 1984 Frame: Grade, C - C EffYrBlt: 1984 PrimeWall WS - Wood/Sheath StoryHght: 0010 - 1 Story No.Units: 1 SecWall: Interior Features BedRooms 2 Electric: MX - MAXIMUM PrmintWall. DW - Drywall FullBath 2 HeatType FHA - FrcdHotAir AvgHt/Fl: 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 Measure Depth DWC - Driv-Concret Y 1 600 AV AV 1984 1 0100-SF Res BI -Front Ft 80 125 FNW6 - WOOD FEN 6' Y 1 220 AV AV 1999 THIS INFORMATION IS BELIEVED TO BE CORRECT AT THIS TIME BUT IT IS SUBJECT TO CHANGE AND IS NOT WARRANTED http://www.pasic.org/prc.asp?prclid=340260800620001 1 / 1 1 /201 1