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Home My WebLink AboutSUBMITTED PAPERSDate: Fee b .0 Recei t# Permit # (]j 87 Planning & Development Services Building & Code Regulations Division 2300 Virginia Ave. Fort Pierce, FL 34982 (772)462-1553 SCANNED BY St. Lucie Count, SPECIALTY PERMIT APPLICATION ❑ Electrical J' Plumbing ❑ HVAC ❑ Fence ❑ Shed ❑ Demolition ❑ Gas ❑ Siding Seepage 2 for instructions and additional paperwork required for specialty pernda 1. Location/Site Address: 2. Parcel ID Number: 3`f9Fa office Use Only Section Township Range Map Page Zoning Land Use Initials 3. Complete Description of Project or Work: CARS To t3E QJ013@ 13Y 4. Owners Information 5. Contractors Information Name: Address: !4 l q City: F;Ou t Ple-4-c r State: L Zip: j� 4%-a Phone: o t" 3 �-3 3 6. Value of Construction: $1 Sob • c)o FL Reg/Cert #: County Cert#: Business Name: Phone: Faa• OWNER'S AFMAvrr: I certify that all of the information contained in this application is correct and that all work will be JvyrM compliance with all applicable laws regulating construction and zoning. PRINT OWNER OR CO�N7 RAC�70R N' SIGNATURE OF OWNERORCO fs'cA/'lp1 STATE OF FLORIDA, COUNTY OF ACKNOWLEDGED BEFORE ME THIS � VDAY OF 20_,L, BY 1 1 / A' �l S WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED AS I TIFICATION. 7. v -7, tic f�uey �� m'>cl (seal) SI NA Y TYPE OR PRINT AME 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 $7500.00 Revised 04/26/2010 Planning & Development Services Department • Building & Code Regulations • • 2300 Virginia Avenue Fort Pierce, Florida 34982 (772)462-1553 OWNERBUILDER 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 1 , I understand that the building official and inspectors are not there to design or give advice on how �to meet - the minimum code. Initial �6�- 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 -� —�� 1 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 #kL 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 medical cost, which could include loss of wages during recovery from their injury. Initial 0 1), 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 o 'ng Dep ent to the Florida State Department of Professional Regulation. Signed and acknowledged on this day of of 20 Owner/Builder Signature STATE OF FLORIDA COUNTY OF _' The foregoing instrum nt was acknowledged before me this day of 20 // , by n2jol - who is personally known to me, or who has nroduced I(.. ,417A .r• as identification. of Title: Print Name of No r (Seal) , Y sion Number SLCPDSD Revised 07/22/2010 AUDREY B. HUMPHREY MY COMMISSION # EE 061159 EXPIRES: March 6, 2015 Bonded Thru Notary Public Underwriters a r-1 + n z y- J 6U-1 t L? )Q (oG:) K Et- Y (Z T , 'tE'RC, E T:L koc.N) N. SE ME HomE- aX ERkoR vjAt�l X CARS T NST R L L n-r I O tJ t. O URTV-Sy OF F. P.U.R . i71 ETE S%4 QA1X, VA ojv C 14 '-wo X �1 R"Fcm OUT 00OR c-,EZ1AL it WTORIFIL E-S AND 111 5 �5�� G IR l5a W AT Et2 H E RTM'R. 1191900 13TO x cz Gnoi R1 P \"ec. F1Q15A caRl;m FILE COPY der M ,, fi 7, Property Appraiser - St.Lucie "^,.mty, FL Page 1 of 1 Norman S Briggs Record: 1 of 1 Property Identification Site Address: 2414 KELLY CT Sec/Town/Range: 21 :35S :40E Map ID: 24/21 N Zor4g: RS-4 Ownership and Mailing Owner: Norman S Briggs Address: 2414 Kelly Ct Fort Pierce FL 34982-5741 PROPERTY RECORD CARD «Prey Next» Spec.Assmnt Taxes Exemptions Permits Home Print ParcellD: 2421-601-0035-000-8 +& V,1CIE Account #: 28996 1 Land Use: SF Res City/Cnty: St Lucie County ! Legal Description ORANGE BLOSSOM ESTATES BLK 4 LOT1 (0.22 AC) (OR 1306-12; 2987-1874; 3098-2853) Sales Information Assessment 2011 Final Total Land and Building Date Price Code Deed Book/Page 2011 Final: 56000 Land Value: 8200Acres : 0.22 5/25/2009 100 0111 QC 3098 / 2853 Assessed: 56000 Building Value: 47800 4/27/2005 5000 01 QC 2987 / 1874 Ag.Credit: 0 Finished Area: 1415 SgFt 6/8/2000 70000 00 WD 1306 / 0012 Exempt: 31000 6/8/2000 55200 00 WD 1306 / 0010 Taxable: 25000 3/29/1996 60000 00 WD 1007 / 0230 Taxes: 555.91 8/16/1995 100 01 WD 0971 / 0812 QQ9/1988 54000 00 DE 0605 / 1718 BUILDING INFORMATION Exterior Features View: RoofCover: SA - Asph Shingle RoofStruct: GA - Gable ExtType: HD+ - HD+ YearBlt: 1963 Frame: Grade: D+ - D+ EffYrBlt: 1977 PrimeWall: BP - Conc Block StoryHght: 0010 - 1 Story No.Units: 1 SecWall: interior Features BedRooms: 2 Electric: MX - MAXIMUM PrmintWall: DW - Drywall FuABath: 2 HeatType: FHA - FrcdHotAir AvgHt/FI: STD 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 City. Units Qual. Cond. YrBlt. No. Land Use Type Measure Depth 3CHT - 3CHT S 1 1 AV AV 1977 1 0100-SF Res BI -Front Ft 85 110 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=242160100350008 12/27/2011