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Home My WebLink AboutSUBMITTED PAPERSDate: O-16 j gee Due• Receipt# i ...,lit # COUNTY F L O R I D A "YY)1 q Planning & Development Services Building & Code Regulations Division 2300 Virginia Ave. Fort Pierce, FL 34982 (772)462-1553 SPECIALTY PERMIT APPLICATION SCABD NNE St. Luce County ❑ Electrical ❑ Plumbing ❑ HVAC ❑ Fence ❑ Shed ❑ Demolition ❑ Gas ❑ Siding Seepage 2 for instructions and additional paperwork required for specialty permits 1. Location/Site Address: Z'WleC 2. Parcel ID Number: � 3 �O� - � Qa -e5)..2 ti% Z/- Township Range Map Pag Land Use Initi � Office Use Sect' qil Only I I 'So Z—iu '251111 N I-AJ Ul-- 3. Comple / —�--5. Contractors Information Name: m� .C�9S /��/ C ► Sri, FL Reg/Cert #: Address: Jy/� ��iy� �i_ C �iP County Cert#: S `� City: �/ / i=�?C/_= State: Business Name: NT N J3Gy)C !"�dai rJ>k� j' Zip: Phone: ?�-�-'y6� G�� Phone: 7751•v77,5=4,6 t Fax: .7.75-( 77% 6. Value of Construction: $ % 'e el d OWNERS 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 con ction and oning. PRINT OWT11tR OR CONTRACTOR NAME SIGN WNER OR CONTRACTOR STATE OF FLORIDA, COUNTY OFv�Lu�y ACKNOWLEDGED BEFORE ME THIS_ DAY OF `� �= 20/,�? BY k)'A WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED ()/ 0 fl� d AS ID IFICATION. p(q M. HUFF Y COMM5SPU E 083530 SIGNATURE OF N T Y YPE O PRIN N OF NOTARYEj� EXPIRES: April 12, 2015 BwddThru Notary Publk 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 $7500.00 Revised 04/26/2010 MAY RESULT FOR NOTICE TO OWNER: FA OVEITvOfEN�TS OR YOUR PROPERTY. MEIFWYOU INTEND TO OB ��INANCINGYCONSULTEWITH IMPR YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEME . 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 workers' compensation for that employee, all as prescribed by law. Your construction must comply with all applicablejaws, 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 le12511 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. �8 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 liablefor 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 rpedical cost, which could include loss of wages during recovery from their injury. Initial l s 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 day of 42�r,61 of 20 . Own r/Bui er Signature STATE OF FLORID COUNTY OF .0 , The foregoing instrume as cknowledged before me this day of , 20, by �� who is personally known to me, or who has produced as identification. - ANGELA M. HUFF MY COMMSSION P FE CI . Signature o otary Type or Prinj Name of Notary EXPIReSi9�li)12, Title: Notary Public Commission Number q�d eabea mu N0"�Y �buc �"°e�� Or ' . ST L E UTILITIES DEP COMM 2368 UIRBINIA AUE FORT PIERCE, FL 34982 RES TERMINAL ID, 883654111 M/F MERCHANT N: 425162443997 VISA IRR #xxxxxxxxxxxx2957 ;ECURITY DEP SALE BATCH: 680316 INVOICE; 816492 DATE: FES 08, 12 TIME: 14:07 ;ERVICE FEE SA: 811 AUTN NO: 94390C ;AME DAY FEE )VERTIME FEE TOTAL #497.00 dETER INSTALL. CUSTOMER COPY 'FC/WATER FPUA CFC CFC/SEWER GUAR. REV. LATERAL $ �-� TOTAL CUSTOMER SIGNATURE NAME OF SPOUSE ST. LUCIE COT NAME Y� C( ACCT. # SERVICE ADDRESS - P.O. BOX 728, FT. PIERCE. FL SUBDIVISION LOT BLOCK i BILLING ADDRESS iA� PHONE # ~� r`f'c' 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 SPOUSE SOCIAL SEC. OFFICE USE ONLY --j DATE RECEIVED ,, i; - T CASH CHK # RECEIVED Br, J 1 Property Appraiser - St.Lucie Counter FL Page 1 of 1 PROPERTY RECORD CARD Douglas C Ball Record: 1 of 2 <<Prev Next» Spec.Assmnt Taxes Exemptions Permits Home Print Property Identification Site Address: 5412 PINETREE DR ParcellD: 3402-602-0274-000-2 Sec/Town/Range: 11 :36S :40E Account #: 36601 Map ID: 34/11 N Land Use: SF Res Zoning: RS-3 City/Cnty: St Lucie County �'• ' Ownership and Mailing Legal Description Owner: Douglas C Ball Toni J Ball INDIAN RIVER ESTATES -UNIT 1- BLK8 LOTS 7 AND 8 (MAP 34/11N) Address: P O Box 12702 (OR 557-720) Fort Pierce FL 34979-2702 Sales Information Assessment 2011 Final Total Land and Building Date Price Code Deed BooklPage 2011 Final: 108800 Land Value: 27700 Acres: 0.91 9/1/1987 18000 00 CV 0557 / 0720 Assessed: 108800 Building Value: 81100 11/1/1979 9300 00 CV 0322 / 2751 Ag.Credit: 0 Finished Area: 1838 SgFt Exempt: 50000 Taxable: 58800 Taxes: 1393.28 BUILDING INFORMATION Exterior Features View: RoofCover: TN - Metal RoofStruct GA - Gable ExtType: HC- - HC- YearBlt: 1989 Frame: Grade: C- - C- EffYrBlt: 1989 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 AvgHUFI: 1/2Bath: 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 1400 AV AV 1989 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=340260202740002 2/8/2012