HomeMy WebLinkAboutSUBMITTED PAPERSDate: Fee Due
REMYER:iitec# Permit #
St. Lucie County Building & Zoning
2300 Virginia Avenue Ft. Pierce, FL 34982-5652
Tel. 561-462-1553
SPECIALTY PERMIT APPLICATION
❑ Electrical ❑ Plumbing ❑ HVAC
❑ Shed ❑ Demolition ❑ Gas
/ Z2
C'
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Seepage 2 for instructions and additional paperwork required for specialty permits o4� '
Lid Fence
❑ Siding
1. Location/Site Address: %,0/7 64ruo7rl 6-,gcr J'OtT Sr oete
2. Parcel ID Number: VI -/OD 6 -00 " ?
IOffice Use Section Township Range Map Page I Zoning Land Use I Ini • is
Only p / 1 4VJV1'
3. Description of Project or Work Activity:
' yi&tt 3 ujo®A A-A-ILLac" Haw Ldf
4. Owners Information
Name: A'AAlA/E ( I OL,4 r-v J 1-G
Address: 9-94v 14412`Tlb e /fizz
City: At tkm e- State: IV
Zip: , �71'r3 Phone:C #j 23
6. Value of Construction:
5. Contractors Information
FL Reg/Cert #: ow y
r
County Cert#:
Business Name:
Phone Fax
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 struction and zo 'ng.
lt u[.aG V 1 CLA
PRINT QUALIFIERS/OWNERS NAME
SIGNATURE OF QUALIFIER/OWNER
ATE OF FLORIDA, COUNTY OF ` l, �I *ACKNOWLEDGED BEFORE ME THIS � DAY OF
, 20 I D, BY I, �✓ 'GO ISLPERSONALLY KNOWN TO ME OR WHO HAS PRODUCED
�j � � �' �jl [� AS IDENTIFICtITION. I O q 6 7 0
AR
TITLE:
St. Lucie County Specialty Permit Application rev. 8/25/05 ding
PE OR PRINT
COMMISSION NUMBER
AUDREY B. HUMPHREY
:=
MY COMMISSION DD 633047
•.,
EXPIRES: March 6, 2011
.'
Bonded Thni Notgry pubfic Underwriters
NOTICE TO OWNER: FAILURE TC 'ORD A NOTICE OF COMMENCEMENT MAY ILT 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.
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 the
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 Specialty Permit Application rev. 8/25/05 dmg
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 applic;bJe laws,
ordinances, building codes, and zoning regulations. Initial im
I understand that the building official and inspectors are not there to design or give advice on how tp 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 liabl 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 relate dical
cost, which could include loss of wages during recovery from their injury. Initial iz
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
4V day of cI/Ul of 20 10
Owner/Builder Signature
STATE OF FLORID
COUNTY OF
The for ing inst ent wa kn wled bef r e this day of , 20/_,
by Y s personally know to me, or who has
pr ced as identification.
tgnature of ff Lary ype or Print Name of Aotary (Seal
Title: Notar ublic Commission Number
AUDREY R. NUMPnHEY
;' MY COMMISSION 0 DD 6MG47
EXPIRES: Mar:;n 6, 2011
1 � 'v'.' 3c�dedThn.:•;steryPUCNcUndnrxrhes
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- + iO;edav Zones
Sections
Historic Structures
- ,0 Address Master
Misc Addresses
Hydrology Names
+ Road ROt+i Dimensioi
+ Lot Lines
Block IVum hers Anno
rV Lot Number Arno
Parcel Dimension Anr RE
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34952
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Annexations
Parcels
Flood ZoixS
Petitions
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Parks & Preserves
Site Plans
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JZoning
_ '"VilciZOnes
Mobile Home Parks
Subdivisions
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+ Ublity SeNice Areas
• I' Zip Codes
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883904.58 1092380.OB Feet
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IF ray, Jan 22, 2010 01:37 PM
Property Appraiser - St.Lucie C ity, FL
Page 1 of 1
PROPERTY RECORD CARD
Dianne Soldevilla
Record: 1 of 1
<<Prev Next» Spec.Assmnt Taxes Exemptions Permits Home Print
Property Identification
,� V�CIE CO
Site Address:
TBD
ParcellD:
Account #:
3414-501-1006-100-8
40901
Sec/Town/Range:
24 :36S :40E
Map ID
34/24N
Land Use:
UNCLSFD ACRG
Zoning:
AR-1
City/Cnty:
St Lucie County
Ownership and Mailing
Legal Description
Owner:
Dianne Soldevilla
ST LUCIE GARDENS 24 36 40 BLK 2 S 165 FT OF N
330 FT OF LOT
Address:
1336 Whiteside Hill Rd
6 (1.25 AC) (MAP 34/24N) (OR 3005-1724)
Wartrace TN 37183
Sales Information
Assessment 2009 Final Total Land and Building
Date
Price Code
Deed
Book/Page
2009 Final: 62500 Land Value: 62500 Acres
1.25
8/13/2008
89900 01
SP
3005 / 1724
Assessed 62500 Building Value: 0
7/16/2008
100 01
CT
3001 / 0471
Ag.Credit 0 Finished Area: 0 SgFt
1/6/2005
125000 00
WD
2151 / 0513
Exempt:
10/9/1997
14000 00
WD
1103 / 2565
Taxable:
6/13/1994
12000 01
WD
0906 / 0448
Taxes: 1215.25
4/18/1989
8500 05
WD
0634 / 0416
3/1 /1985
6000 00
CV
0458 / 0637
BUILDING INFORMATION
No Sketch
Available
No Image
Available
Exterior Features
View.
RoofCover
RoofStruct:
ExtType:
YearBlt:
Frame:
Grade.
EffYrBlt:
PrimeWall:
StoryHght:
No.Units:
SecWall:
Interior Features
BedRooms:
Electric:
- PrmintWall:
FullBath:
HeatType:
- AvgHt/Fl:
1/2Bath:
HeatFuel:
- Prm.Flors: -
%A/C:
%Heated:
%Sprinkled:
Special Features and Yard Items
Land Information
Type Y/S Qty. Units
Qual. Cond. Y(BIt.
No. Land Use Type Measure Depth
1 9900-UNCLSFD ACRG 528 -Acres 1.25
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=341450110061008
1 /22/2010
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Srr SMtrCT 3 {�7AS
184-068
i..dtrSL
JOSEPH E. SMITH, CLERK OF THE CIRCUIT COURT — SAINT LUCIE COUNTY
FILE # 3436053 OR B 3166 PAGE 1668, Recorded 01/29/201 03:03 PM
AFTER RECORDING -RETURN TO:
PERMIT NUMBER:
IPP I • 0206 NOTICE OF COMMENCEMENT
The undersigned hereby given notice that improvement will be made to certain real property, and in accordance with Chapter 713,
Florida statutes the following information is provided in the Notice of commencement. 9
I - DESCRIPTION (()F PROPERTY a al descr'ption and street address) TAX FOLIO NUMBER:Ao Y- !0/. Ze 0 4,' a
SUBDIVISION'+r "��BBf - i TRACT LOT it BLDG UNIT
2. GENERAL DESCRIPTION OF IMPROVEMENT: 6N4G 0' 057JF �r de&t�
3. OWNER INFORMATION: a. Name %Z/AA46 ts' b // / n
b. Address '799 12 6um rf i FL 0ner Sr L-tr"r c. interest in property
d. Name and address of fee simple titleholder (if other than owner)
4. CONTRACTOR'S NAME, ADDRESS AND PHONE NUMBER: _
°�✓� fa✓ILOLR
5. SURETY'S NAME, ADDRESS AND PHONE NUMBER AND BOND AMOUNT:
6. LENDER'S NAME, ADDRESS AND PHONE NUMBER:
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by
Section 713.13 (1)(a) 7., Florida Statutes:
NAME, ADDRESS AND PHONE NUMBER:
8. In addition to himself or herself, Owner designates the following to receive a copy of the Lienor's Notice as provided in Section
713.13 (1)(b), Florida Statutes:
NAME, ADDRESS AND PHONE NUMBER:
9. Expiration date of notice of commencement (the expiration date is 1 year from the date of recording unless a different date is
specified) , 20,_
Signature of Owner or Print Name and Provide Signatory's Tllle/Ofrice
Owner's Authorized Officer/Director/Partner/Manager
State of Florida
County of '
20it
The going instrument as acknowledged before me this _1W day of
,
as
e.g. Owner, officer, trustee, attorney in fact)
(Name of person) p" (Type of authority...
For =DidNA/P }{)LilyVil.11112
(Nume of party on behalf of whom instrument was executed) Personally own
or produced the following type of ID: _
A,I C'Ey 1'�' A . 1/0 f aidJAOn
-
(Printed Name iff Notary Public) /(Signature of Notary lic)
Under penalties of perjury, I declare that I have read the foregoing and that the facts
in it are true to the best of my knowledge and
belief (section 92.525, Florida Statutes).
Signature(s) of Owner(s) or Owner(s)' Authorized OMcer/Director/Partner/Monager who signed above:
By: BY
Re.. aRlfIV2UnIRuwd'mrl
,.• AUDREY B. www
F
MY r,%"SS10N t DD t N7n
., LORE&A4rchQpot1
. ttondtanwttoun �mta txar«IM
STATE OF FLORIDA
,:r
ST. LUCIE COUNTY
THIS IS TO CERTIFY THAT THIS IS A
►�" �'Rc ,
TRUE ARID CORRECT COPY OF THEORIGINAL
E SMITy. C
By:
Date