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SPECIALTY PERMIT APPLICATION
Date: ' Fee Due: Pos. Permit # p Planning & Development Services Building & Code Regulations Division 2300 Virginia Ave. Fort Pierce, FL 34982 (772)462-1553 SPECIALTY PERMIT APPLICATION ❑ Electrical ❑ Plumbing ❑ AC ❑ Fence ❑ Shed ❑ Demolition ® Gas ❑ Siding Seepage 2 for instructions'and additional paperwork required for specialty permits 1. Location/Site Address: tfD k 2. Parcel ID Number:-44'D-:zx, e:A C5 cz, © I C> C> C:�, ®_ e, 1 a6-- M 41.2yZv*ytl� WI-1-1 - T cam,, Office Use Only Section Township Range Map Page Zoning Land Use Initials 3. Complete Description of((Project or Work: ,{ (n� �L-11olan d U /s���,�,, ,� �(�,.p�� ��„d mG 2Cugx- , .� t' �Q 121C ;q,--� I !) n en..1 n 11 ��® iira Is rn-ll -0i CLJLU . — V11--pl r `,'` -,oA %r � I1 �ceG lion ucl 4. Owners Information t 5. Contractors Information 1 �J Name: �,, `� FL Reg/Cert #: Address: v� '�— County Cert#: City: C�� State: Business Name: ; �"s L Zip: 3�g� �� Phone: `oagPhonela (Q��Fax: b1 a 3 Cx, 6. Value of Construction: $ r 1-.. to OwNER'S AFFIDAVIT: I certify that all of the information contained in cation is d that all work will be done in compliance with all applicable laws regulatin oxs ction ang. (Ys=-NNC, 4LL-ts oN PRINT OWNER OR CONTRACTOR NAME STATE OF FLORIDA, COUNTY OF ACKNOWLEDGED BEFORE ME THIS WHO IS PERSONALLY KNOWN TO ME AS IDENTIFICATION. SIGNATURE OF NOTARY COMMISSION NUMBER DAY OF 20 BY OR WHO HAS PRODUCED OR (seal) TYPE OR PRINT NAME OF NOTARY 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 Revl,ed 01/26/2010 NOTICE TO OWNER: FAILURE TG.,_'CORD A NOTICE OF COMNIENCEMENT MAY '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. I INSTRUCTIONS Please complete all information in th 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 proided with this application includes: 1. Location/Site Address 2. Parcel ID Number 3. Description of Project or Work 4. Owner Information 5. Contractor Information 6. Value of.Construction ❑ Gas . ❑ Shed: ❑ Fence ❑ Siding Attach 2 Attach 2 plot Attach 2 plot Attach 2 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. 7ty 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. schematics with tank size,location, and BTU of each appliance ins, 2 copies of DCA letter and plans, 2 anchor specifications ans showing location of fence height of fence and type of fence 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 hou-s (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. Planning & Development Services Building & Code Regulation Division 2300 Virginia Avenue Fort Pierce, FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Permit 1 u Address 511 NW WINTERS CREEK RD I Owner(s) JOHNAFSHAR PALM CITY 34990 Historic No Jurisdiction St. Lucie County Parcel # 4422-810-0010-000/8 S/D Harbour Ridge Plat #20 Block Lot # G FLU RE Zoning PUD Flood Mal 405F Flood Elevation Flood Zone X Application Type Over the Counter Permit Status Expired 0809-0106 Activity Type Expiration 01/18/2010 Other -Specify 705 Permit Type Gas Piping Date Applied 09/10/2008 Taken By humphreya Location I Mainland Date Issued 09/11/2008 Issued By gersteml lat Fee Valuation $2,300.00 Date Finaled Posted By Date Voided Please explain in Additional Comme Job Address 511 NW WINTERS CREEK RD Category Type I'Property Owner (Property Owner Contractor Name Business Address Email GENEVIEVE VITAGLIANO 13501 COCO PLUM CT PALM CITY FL Open Contractor . Registration Phone (561) 987-0298 ext Fax ( ) - Mobile ( ) - Pager ( ) - Units 1 00 Floors am Buildings m # Bedrooms # Bathrooms Total Sq. Ft. 0.00 Min Flood Elevation Flood Map 405F Flood Zone FCC 404 Gas Piping NOC Required ❑ VOC Receivec ❑ NOC Expiration Setbacks Front Back Left Side Right Side Job Description Additional Info NSTALLATION OF UNDERGROUND PROPANE TANK (1000 GALLONS)AND GAS LINES FOR COOKTOP , 2 =IREPLACES, POOL HEATERS GRILLAND 3 FIREPITS Please include the date and your name when adding information. 3-01-2010 RENEWAL OF PERMIT $125:00-a HUMPHREY 3/16/09 revision was pickup by gary (L. gerstemeier) 3/16/09 called and left msg on machine revision ready for pu (I.gerstemeier) 3/11/2009 revision to plan - additional 500 gallon underground tank added gas line on exterior changed. grill ocatation changed firepit added gave to inspection. (I.gerstemeier) 3-10-2008 CALLED FOR PICK -UP -A HUMPHREY i.20.09 - REVISION CHANGING OF 1000 GALLON UNDER GROUND PROPANE TANK LOCATION, ADD GAS Reviews s .e= Job Address 511 NW WINTERS CREEK RD Permit Type Gas Piping s: Application Type Over the Counter Permit Other Activity Type Flood Elevatio'1 Flood Zone 0809-0106 Stories Minimum Floor Elevation Automatic Sprinkler System? Rovipw Tvna Sfatus Reviewed By Date Sent Date Started Date Completes Revisions Complete arnoldk 07/20/2009 07/20/2009 Revisions Complete arnoldk 07/20/2009 07/20/2009 Entered Number Date Entered By Complied? Compliance Date Comments Inspections Planning & Development Services Online address: • i Building & Code Regulation Division http:/%www.stlucieco.org/planning/permitting.htm 2300 Virginia Avenue Quick Links I Fort Pierce, FL 34982 Permit Status Lookup. Phone: (772) 462-2172 Fax: (772) 462-6443 Online Building Inspection System - i 06 Expired ......................... .......... ..........._.......... ................... _......... ._.... . _. Job Address 511 NW WINTERS CREEK RD 'ermitType Gas Piping j I.. _.... . ...-.... -------._....------------..... kpplication Type Over the Counter Permit j Other Activity Type l Stories �1 Inspection Area .Job Uescri tion j: `ISTALLATION OF UNDERGROUND PROPANE TANK (1000 GALLONS) AND GAS LINES FOR COOKTOP , 2 FIREPLACES, POOL HEATERS GRILLAND 3 FIREPITS !'roperty Owner Name GENEVIEVE VITAGLIANO oritractor Business Name inspection Notes i Phone (561) 987-0298 REVISION TO PLANS CHANGE OF 100 GALLON UDER GROUND PROPANE TANK LOCATION, ADD GAS LINE TO TIE IN TANKS AND LINES, DELETE TIKI TORCHES, ADD ANOTHER FIREPIT AND CHANGE GENERATOR LOCATION Date Scheduled Prioritl Status Max Expiration Date 03/05/2010 Inspector (Code) Inspector Date Inspected 3 490 Rough Gas (Inside) 1 490 Rough Gas (Inside) 1 464 Gas Piping (Outside) 2 r, 999 Final Inspection 3 493 Final Gas 3 i. I!RAccess 07/23/2009 490 Rough Gas (Inside) 1 Disapproved -Reinspect Fe Greg Smyth 07/23/2009 '�:orie Gerstemeier 06/16/2009 900 Plan Revision 1 Approved Ken Arnold 06/16/2009 r drey Humphrey u 07/20/2009 900 Plan Revision 1 Approved Ken Arnold 07/20/2009 r ! i I •f 1� is '.0spector Comments Zs -inspection 1