HomeMy WebLinkAboutSPECIALTY PERMIT APPLICATIONr
Planning & Development Services
Building & Code Regulations Division
2300 Virginia Ave.
Fort Pierce, FL 34982
(772)462.1553
SPECIALTY PERMIT APPLICATION
electrical ❑ Plumbing ❑ HVAC ❑ Fence
Shed ❑ Demolition ❑ Gas ❑ Siding
Seepage 2 for instructions and additional paperwork required for specialty permits
1. Location/Site Address: / d
2. Parcel ID Number: ! 3o I- CD % O
3.
SCANNED
BY
St. Lucie County
Township Range Map Page Wing f I La Use Initials
Office Use Sectlon
only
4. Owners In ormation f 5. Contractors Information
r1A ll
Name: t(
ry w act' 5Ur y�
Address: i I D pm SCt cojI � I )
City: � - r State: F�
Zip: I "I Phone: %g -062:'
6. Value of Construction: $ d aqj
OwNEws AFFIDAVrT:
j r compliance with all applicable
JP�etw v tJnaklyh
PRINT OWNER ORCONTRA ORNAME
STATE OF FLORIDA, COUNTY
ACKNOWLEDGED BEFORE ME
WHO IS PERSONALLY KNOWN TO ME_ OR WHO
A ENTB�7CATTON
SIGNATURE CC110TARY
COMMISSION NUMBER
FL Reg/Cert #:
County Cert#:
Business Name:
in this application is correct and that all work will be
g construction and zoning/
�f
in
. ANGELAM.HUFF
MYC0MMS510N 4 EE 08=
"FIRES: April 12, 2015
NOTICE TO OWNER: FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULTZN'7G:
IMPROVEMENTS TO YOUR PROPERTY. IF YOU RVTEND TO OBTAIN FINANCING, CONSULT
LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
EXEMPT: A/C -HEAT REPLACEMENT WFFH CONTRACT UNDER S7500.00
Revised 04/26/2010