HomeMy WebLinkAboutSUBMITTED PAPERSFCOUNTY
F L 0 R I D A —All*
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Planning & Development Services
Building & Code Regulations Division
2300 Virginia Ave.
Fort Pierce, FL 34982
(772)462-1553
SCANNED
St. Lu BY
cie coljrltv,
SPECIALTY PERMIT APPLICATION
• Electrical 0/p/lumbing 0 HVAC 0 Fence
• Shed 11 Demolition 0 Gas 0 Siding
Seepage 2for instructions and additionalpaperwork requiredfor specialty permits
1. Location/Site Address: —1) P,
2. Parcel ED Number: -i;5 ;�? Z '�O;r '/ Aa-'e R -5�
Office Use
Only
sectiorl
Township
Range
I
Map Page
— nmg
an se
of
K�y
I a
3. Complete Description of Project or Work: 472,�'
z, X�A' 15�Cg 72)
4. Owners Information 5. Contractors Information
Name: e�111�lck S FL Reg/Cert #:
Address: County Cert#:
City: State: Business Name:
Zip: '23 Phone: -7� Fax:
6. Value of Construction: S C2
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 construction and zoning.
%jd7Lkt-0F'6WNtR OR 019TRACTOR
PRINT OWNER OR CONTRACTOR N
STATE OF FLORIDA, COUNTY OF
BEFORE ME TIIIS DAY OF 20 Y A vtc_-
20
ACKNOWLEDGED
PRODUCED
WHO IS PERSONALLY KNOWN TO ME OR WHO PRODUCED
AS IFICA
AS IFICATI
An I J s
M
CR
Sii A OF ARY TYPE OR PRINT NANF OF NOTARY
9V V-
COMMISSION NUMBER
rrn"
NOTICE TO OWNER: FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYINNG
R
W
IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
oft
LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
EXEMPT:A/C-HEAT REPLACEMENT WITH CONTRACT UNDER $7500.00
Revised 04126/2010
Planning & Development Services Department
81 N Building & Code Regulations
2300 Virginia Avenue
a
a Fort Pierce, Florida 34982
-1553
(772)462
OWNERIBUILDER 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 app
ordinances, building codes, and zoning regulations. Initial2an
I understand that the building official and inspectors are not there to design or give advice on how to meet
the minimum code.
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
If for some reason they do not possess a license, I may be responsible and liable the
licensed in this jurisdiction. Initial�7
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 re=
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 owneribuilder exemption shall be reported by the Building and
fessional Regulation. Signed and acknowledged on this
z ing Departm nt to the Florida State Department of Pro
day of 7�= of 20 4_9=_ �U_ �
O��/Builder Signatune
STATE OF FL�OWRIDA
COUNTY 9OF _
The foregoing in strum nt was acknowledged before me this I? day of __,20
who is pi�r_sonally kno,4r(_ to me, or who has
by as identification.
prod ed
& & / -� . ) (7.
�Siogpnnature f T or Print NJ
ofNot y (Seal
y r_
Commission N
Title: Notar ublic
AUDREYB.HuMPHREY
SLCPDSD Revised 07122/2010 OMMISSION # EE 061159
my C
E PIRE& March 6, 2015
X
Iru Notary Public Underviriters
Bonded TI
Property Appraiser - St.Lucie Ctnty, FL
Page I of I
PROPERTY RECORD CARD
Clyde S Graves Record: 1 of 1 <<Prev Next Spec.Assmnt
Property Identification
Taxes Exemptions Permits Home Print
" \,\3c'E 0"
Site Address:
5910 SPRUCE DR
ParcelID:
3402-610-0428-000-2
Sec/Town/Range:
12 :36S :40E
Account
38552
Map ID.
34/12S
Land Use-
SF Res
Zoning:
RS-4
City/Cnty�
St Lucie County
Ownership and Mailing
Legal Description
Owner:
Clyde S Graves Miriam A Graves
INDIAN RIVER ESTATES -UNIT 09- BLK 85 LOT 4 (MAP 34/12S) (OR
Address:
5910 Spruce Dr
517-1267)
Fort Pierce FL 34982-3794
Sales Information
Assessment 2011 Final Total Land and Building
Date Price Code Deed
Book/Page
2011 Final:
59800 Land Value:
6900 Acres 0.23
10/1/1986
60000 00 CV
0517/1267
Assessed:
59800 Building Value:
52900
10/1/1985
52000 00 CV
0478/0592
Ag.Credit�
0 Finished Area
1542 SqFt
10/1/1978
3000 01 CV
0297/0633
Exempt:
34800
Taxable.
25000
Taxes:
535�84
BUILDING INFORMATION
Exterior Features
View:
RoofCover:
SD - Dim Shingle
RoofStruct:
GA - Gable
ExtType.
HC- - HC-
YearBlt:
1979
Frame�
Grade:
C_ - C_
EffYrBIt:
1979
PrimeWall:
BS - CB Stucco
StoryHght:
0010 - 1 Story
No.Units:
1
SecWall�
Interior Features
BedRooms:
3
Electric:
MX - MAXIMUM
PrmlntWall:
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
WS Qty.
Units Qual Cond.
YrBl*. No. La. -id Use
Type
Measure Depth
DWC - Driv-Concret
Y 1
600 AV AV
1979 1 0100-SF Res
215 -Front Ft
80 125
FEN4 - CHAINLINK 4' Y 1 80 AV AV 1979
THIS INFORMATION IS BELIEVED TO BE CORRECT AT THIS TIME BUT IT IS SUBJECT TO CHANGE AND IS NOT WARRANTED
http://www.pasIc.org/prc.asp?prcIid=340261004280002 1/9/2012
SEWER
RES
METER SZ.
M/F
$ 100
IRR
SECURITY DEP
SERVICE FEE
SAME DAY FEE
OVERTIME FEE
METERINSTALL.
CFC/WATER
FPUA CFC
CFC/SEWER
GUAR. REV.
LATERAL
TOTAL
ST. LUCIE COUNTY UTILITIES - F— �OX 728. FT. PIERCE. FL 34982
NAME
ACCT. #
SERVICE ADDRESS 0
J—
SUBDIVISION i —
I
BILLINGADDRESS
LOT_�jI
BLOCK
I
PHONE # 6, MOVE IN/CLOSING DATE
This application hereb� request and authorizes the Utility to render water and/or sewage disposal
services to the premis s described above in accordance with the Utilities present or future rates,
rules and regulations, hich by reference are made a part of this contract. Applicant agrees to pay
the Utility promptly r such services in accordance with the established rules and regulations.
f I
CUSTOMERS DEPO' ITS ARE NON NEGOTIABLE OR TRANSFERABLE.
CUSTOMER SOCIA]
SIGNATURE ;PEODUID
NAME OF SPOUSE S1
OF $1
,CA psi
DATE RECEIVEDJ!.// CASH
SEC/
SOCIAL SEC.
RECEIVED BY AT I-