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Home My WebLink AboutSUBMITTED PAPERSDate: /'Z. z* t( IFee Due_ , , 6V. Receipt# Permit #' 'C(0)UNTY F L O R I D A Planning & Development Services Building & Code Regulations Division 2300 Virginia Ave. Fort Pierce, FL 34982 (772)462-1553 sc4 �NED St I -1cie count SPECIALTY PERMIT APPLICATION ❑ Electrical ❑ Plumbing ❑ HVAC L1 Fence ❑ Shed ❑ Demolition ❑ Gas ❑ Siding Seepage 2 for instructions and additional paperwork required for specialty permits 1. Location/Site Address: # t5 r� / m [ e F�I &- rc *— �l 2. Parcel ID Number: # y3O,.? l— 0017-0d0-1 Ort; ea Only Section Township Range Map Page Zoning Land Use Initials m X 3. Complete Description of Project or Work: 4 4 R-c.p lc cc aJ lMc66 d t) 10 Owners Information -I 5. Contractors Information Name: ! / /y`. � SexL,^ FL Reg/Cert #: Address: `��tl {>1y Lxrt-r- City: fs IefC e State: �. Zip: G Phone: 7Y 6. Value of Construction: $ 2-co. au County Cert#: Business Name: Phone: Fax: 772 - �d l - 7y- � 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 regulatinAonstruction and ping. PRINT OWNER OR CONTRACTOR NAIE, \ GNATURE OF OWNER OR ONTRACTOR STATE OF FLORIDA, COUNTY ACKNOWLEDGED BEFO E T S DAY OF' e WHO IS PERSONAL KNOWN ME OR WHO HAS PRODUCED 20 , BY AS IDENTIFICATION LhaA . Pitrn�� SIGNATURE OF N Y TYPE OR PRINT NAW OF NOTARY COMMISSION NUMBER NOTICE TO OWNER: FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. EXEMPT: A/C -HEAT REPLACEMENT WITH CONTRACT UNDER $7500.00 I� a � ��o c z ®rl co co n c Mai a c�� i FOR Revised 04126/2010 NOTICE TO OWNER: FAILURE TI CORD A NOTICE OF COMMENCEMENT MAN IULT 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 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. 'r { 44 r iesday, Dec 28. 2011 0210 PM 0 V,n-JU C'hacn G n k. f1. e'er ?—erm',+ ; I1 :9- o FIL COPY t r� Ttuo %ions Fcoicc r nI /05 - `61ikn 1 C-5- C %�q� ►� C. k Planning & Development Services Department ® Building & Code Regulations 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 iniiiailicab lws, ordinances, building codes, and zoning regulations. I understand that the building official and inspectors are not there to design or give advice on how to et 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 maybe responsible and liable for the Initial cost of the license. 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 Z—..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 1 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 2 Fi' day of of 20 wnerBuilder Signa e r STATE OF FLORID%�Li L. �� — COUNTY OF �StF� �c _ , 20 /�The before me this day of foregoing instrum@nt was acknowledged by Lp !2 �'! -5� i0 /V who is personally own to me, or who hasaentification. p�uced/ e or Print Name o otary (Seal) Signature of tary Number Title: Notary PublicCommission SLCPDSD Revised 07/22/2010 Property Appraiser - St.Lucie r-linty, FL Page 1 of 1 PROPERTY RECORD CARD Larry Sexton Record: 1 of 1 <<Prev Next» Spec.Assmnt Taxes Exemptions Permits Home Print Property Identification ,k�,�CIE CO Site Address 5164 Amy Ln ParcellD: 211 oil I-1-11, 1 Sec/Town/Range: 30 :34S :40E Account #: 10270 Map ID: 14/30S Land Use: Mob Homes Zoning. RMH-5 City/Cnty St Lucie County Ownership and Mailing Legal Description Owner: Larry Sexton GREEN ACRES UNIT TWO S/D BLK 4 LOT 3 (OR 3204-2599) Address: 5164 Amy Ln Fort Pierce FL 34946-9062 Sales Information Assessment 2011 Final Total Land and Building Date Price Code Deed Book/Page 2011 Final: 43100 Land Value: 7500 Acres: 0.17 6/10/2010 100 0111 QC 3204 / 2599 Assessed: 43100 Building Value: 35600 7/10/2000 100 01 WD 1312 / 2709 Ag.Credit: 0 Finished Area: 1292 SgFt 5/8/1998 100 01 WD 1149 / 0002 Exempt: 25000 12/1/1985 7200 01 CV 0486 / 1154 Taxable: 18100 2/1/1985 4900 01 CV 0458 / 1211 Taxes: 368.28 BUILDING INFORMATION nor• i <u°i1° rae, Exterior Features View RoofCover. - RoofStruct: �r ExtType: MHL - MHL YearBlt 1994 Frame: Grade: MANH - MANH EffYrBlt 1994 PrimeWall: StoryHght. 0010 - 1 Story No.Units: 1 SecWall Interior Features BedRooms: 2 Electric: - PrmintWall: - FullBath 0 HeatType. FHA - FrcdHotAir AvgHt/FI 1/26ath: 0 HeatFuel ELEC - Electric Prm.Flors: - %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 FEN4 - CHAINLINK 4' Y 1 250 AV AV 1979 1 0200-Mob Homes 205 -Front Ft 75 100 THIS INFORMATION IS BELIEVED TO BE CORRECT AT THIS TIME BUT IT IS SUBJECT TO CHANGE AND IS NOT WARRANTED. 1 http://www.pasIc.org/prc.asp?prcIId=143070100270001 12/28/2011 Se t) c e h2iy�ha t9 � J4/ncC.