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Home My WebLink AboutSUBMITTED PAPERSlog• , 1 Date: Fee Due: Recei t# Permit # Planning & Development Services sqg wNFo - Building & Code Regulations Division St / 8V 2300 Virginia Ave. (/Ci(? C M Fort Pierce, FL 34982 OUnty (772)462-1553 SPECIALTY PERMIT APPLICATION ❑ Electrical ❑ Plumbing ❑ HVAC ❑ Fence ❑ Shed ❑ Demolition ❑ Gas ❑ Siding See page 2 for instructions and additional paperwork required for specialty permits 1. Location/Site Address: 9 (,-3 2. Parcel ID Number: �.7'C C) -�" ^ Qd 0 �o ^ (D I �� ` LK Dc -) � Office Use Only Section Township Range I Map Page Zoning Land Use Initials 3. Complete Description of Project or Work: \�J IR - Ca�v% L&)CNq't 4. Owners Information 5. Contractors Information Name: � .RQ C*, %AA" �C�� - FL Reg/Cert #: Address: y' O 1 rn S�P�I County Cert#: City: 1�-' Q State: B�� jjone Fax Business Name: Jel zip: Yj"3- Phone " YA• (-DC) 6. Value of Construction: $ o� OWNERS AFFIDAVIT: I certify that all of the information contained in this application is correct and that all work will be done in compliancewithall applicable laws regulating construction and zoning. PRINT OWNER OR CONTRACTOR N A e ` h QSIAT%UIUOF OWNER OR CONTRACTOR STATE OF FLORIDA, COUNTY OF ACKNOWLEDGED BEFORE ME THIS COMMISSION NUMBER NOTICE TO OWNER: EXEMPT 1�) /r 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. A/C -HEAT REPLACEMENT WITH CONTRACT UNDER $7500.00 Revised 04/26/2010 • G NOTICE TO OWNER: FAILURE TO RECORD A NOTICE OF CONEvIENCEMENT MAY R sULT IN YOUR PAYING TWICE FOR II"ROVEMENTS 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. EMOP CITYA I p. R '•. 5� .. . 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 ordir ►ces. 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 appl' able 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 how to 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 liable for the cost of the license. Initial its 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 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 Departm4ZA 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 oregoing instrum was acknowledged before me thisah"day of , 20_t_L, by , who is personally known to me, or who has pr uced as identification. Signature of N y • Type o mt Name of Notary 4e rnI aeFr Title: Not Pu lic Commission Number SLCPDSD Revised 07/22/2010 '— .eN:+'PyAUDREY B. HUMPHREY `O MY COMMISSION # FIE 061159 +: P••r ° EXPIRES: Marcy: r , 2015 FyP+ Bonded Thru Notary Pubrw thrderwriters _ WATER _ COMM SEWER _ RES METER SZ. _ M/F IRR _ SECURITY DEP SERVICE FEE SAME DAY FEE OVERTIME FEE i METER INSTALL. CFC/WATER FPUA CFC CFC/SEWER GUAR. REV. LATERAL X TOTAL ST LUCIE COUNTY UTILITIES - P.O. BOX 728, FT. PIERCE, FL 34982 NAME ACCT. # SERVICE ADDRESS 1 I" L: M i �.i-y I k 1� C SUBDIVISION t. J ��. �� LOT BLOCK BILLINGhAf DDRESS j PHONE # -7a �p_� MOVE IN/CLOSING DATE i 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. CUSTOMER j ( ��aV) v t� SIGNATURE -� A"a NAME OF SPOUSE SOCIAL SEC/ . FED ID SPOUSE SOCIAL SEC, ��rr �( OFFICE USE ONLY DATE RECEIVED .' �tr' +=� v CASH CHK # c%-xl.�� RECEIVED BY 4t&, Property Appraiser - St.Lucie 1--nty, FL Page 1 of 1 Dreama L Singley Record: 1 of 1 Property Identification Site Address: 901 MIDWAY RD Sec/Town/Range: 02 :36S :40E Map ID: 34/02N Zoning: RS-3 Ownership and Mailing Owner: Dreama L Singley Address: 901 E Midway Rd Fort Pierce FL 34982-8513 Sales Information Date Price Gccie Deed 8/24/2011 100 0116 QC 8/29/2005 55600 01 QC 9/4/1997 4000 01 WD PROPERTY RECORD CARD <<Prev Next» Spec.Assmnt Taxes Exemptions Permits Home Print �\_UCIE 0O ParcellD: 3402-606-0158-000-5 Account #: 138348 Land Use: SF Res City/Cnty: St Lucie County Legal Description INDIAN RIVER ESTATES -UNIT 05-BLK 26 THAT PART OF LOT 3 BOUNDED ON E BY A LI COMM 4 FT WOF NE COR OF More... Assessment 2011 Final Total Land and Building Book/Page 2011 Final: 67300 Land Value: 19400 Acres: 0.84 3319 / 1079 Assessed: 67300 Building Value: 47900 2353 / 2974 Ag.Credit: 0 Finished Area: 1271 SgFt 1097 / 2686 Exempt: 42300 Taxable: 25000 Taxes: 644.93 BUILDING INFORMATION Exterior Features B View: RoofCover: FS - Fibrglss Shg RoofStruct: HP - Hip ExtType: HC- - HC- YearBlt: 1997 Frame: Grade: C- - C- EffYrBlt: 1997 PrimeWall: FS - Firm 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: STD 1/213ath: 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 3CNT - 3CNT S 1 1 AV AV 1997 1 0100-SF Res 220 -Front Ft 121.6 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 Depth 300 http://www.paslc.org/prc.asp?prclld=340260601580005 12/20/2011