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HomeMy WebLinkAboutSPECIALTY PERMIT APPLICATION1 Date IZ,Fee Due• Vie aft Receipt# I Permit# l)3 09 St. Lucie County Building & Zoning -- 2300 Virginia Avenue Ft. Pierce, FL 34982-5652 <4't Tel. 462-1553 SPECIALTY PERMIT APPLICATION SCANNED BY ❑ Electrical ❑Plumbing ❑ HVAC )� Fence St. Lucie Countv ❑ Shed ❑ Demolition ❑ Gas ❑ Siding Seepage 2 for instructions and additional paperwork required for specialty permits 1. Location/Site Address: (--1 n �D i CiC('Irl s o n PX ✓ CL CC.) 2. Parcel ID Number: 3 4 l 5 ` ! 0 (a - o o o -r — ©o o — q Office Use ISection —Jownship I RaDge I Map Page I Zonin 9F 1Land Use Initials Only 3 3. Description ofProjector Work Activity: :ETQ-1 19Lt_. I -IS t - S t (-h-6-M 1' VL knC e- +3 f n t= cl C3) 51 Y S 1 WA &igA r-e.s - 4. Owne�r'sy �Information Name: None _ 1) eX n Address: (4'1 $�T �tcki nse,� TfX City: PSI, - State: 5. Contractors Information FL Reg/Cert #: County Cert#: t Business Name:ual_._�L� Ifu1C� `Ol\�Y/D�rhMMM7C Zip: 3 R rJ o� Phone:3-D- 6 / V`f Phone 7i-91a (6Fax 9—) L (0 / n 6. Value of Construction: $ 5350, 00 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 z ning. JayW3 . �'i'e�sTt�r3 PRINT QUALIFIERS/OWNERS NAME SIGNAT OF QUA-LIFIER/OWNER STATE OF FLORIDA. COUNTY OF JT. L (A -A— ACKNOWLEDGED BEFORE ME THIS L I k DAY OF 2009 BY TITLE: NOTARY PUBLIC St. Lucie County Specialty Permit Application rev. 8/25/05 dmg IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED IDENTIFICATION. (sea)) COMMISSION NUMBER NU FARY PUBLIC -STATE OF RORMA *Deborah A. Dempsey Commission # DDS43963 Expires: APR. 24, 2010 Bonded Thtu Atlantic Bonding co., Inc. 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 $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 Indicate the street address or general location of the property where the building activity is taking place. 2. Parcel ID Number Indicate the tax identification -number of the property where the building activity is taking place. 3. Description of Project or Work Activity" 'Fully describe the'activity to take place. 4. Owner Information Indicate the name and address of the owner of the property on which' activity is taking place; 5. Contractor Information, Indicate the State of Florida registration number (if applicable), St. Lucie County,contractor license number and the name of the business doing the work: 6. Value of Construction ' 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 I , _ 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), Mohday through Friday. i 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 ding