HomeMy WebLinkAboutSPECIALITY PEMIT APPLICATION7�
.�� St. Lucie County Building & Zoning
P3 2300 Virginia Avenue Ft. Pierce, FL 34982-5652
„ ��� Tel. 561-462-1553
SPECIALTY PERMIT APPLICATION
SCANNED
/ BY
❑ Electrical a -Plumbing ❑ HVAC ❑ Fence St. Lucie County
❑ Shed ❑ Demolition ❑ Gas ❑ Siding
Seepage 2 for instructions and additional paperwork required far specialty permits
1. Location/Site Address: C / U I viceJ.O ttidt�
2. Parcel ID Number:
Q
Office Use
Section
Township
Range
Map Page
Zoning Land Use
I Initials
Only
3. Description of Projector Work Activity:
4. Owners Information
Name:- Zviy - U V f ISOtn
Address: 6 /b/ 73Uc kc"�` Jcr
5. Contractors Information
FL Reg/Cert #:
County Cert#: 9333
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City:
a-
-csf-CP—State: Business Name:
� e l ry c
Zip:
���/Sa
Phone��-Phone��� (-23�S
6. Value of Construction: S
OWNER'S AFFIDAVIT: I certify that all of the information contained in this application is correct and that all work will be done
n in compliance with all applicable laws regulating d zoning. 77;
PRINT QUALIFIERS/OWNERS NAME-1.1 < O SIGNAT RE OF QUALIFIER/OWNER
•
STT�ATE OF FLORIDA, COUNTY OF
�r 0 `�""`^' ACKNOWLEDGED BEFORE ME THIS
/
DAY OF
/ r , 2((-Q, BY
is WHO IS PERSONALLY NO O ME OR WHO
HAS PRODUCED
AS IDENTIFICATION.
y^
40 17)
SIGNATURE OF TAR
TYP O PRINT NAME OF NOTARY/
TITLE: NOTARY PUB
COMMISSION NUMBER
L,+s. �'r�'V}:'s AUDREY 6. HUMPHREY
MYCDM
St. Lucie County Specialty Permit Application rev. 8/25/05 dmg t � Mlsstorl a Dp e>a+oa�
�,� EkPIHEs; March B, 2of t R'„ Battletl Tram Nogrypubiia UntleM-raters
NOTICE TO OWNER: FAILURE TO'xr.CORD A NOTICE OF COMMENCEMENT MAYI jiESULT 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 the
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.
St. Lucie County Specialty Permit Application rev. 8/25/05 drug