HomeMy WebLinkAboutSPECIALTY PERMIT APPLICATIONFee Duet -
0
IJJ Electrical
❑ Shed
St. Lucie County Building & Zoning
2300.Virginia Avenue Ft. Pierce, FL 34982-5652
Tel. 561462-1553
SPECIALTY PERMIT APPLICATION
❑ Plumbing ❑ HVAC El Fence
❑ Demolition ❑ Gas ❑ Siding
SCANNED
BY
St. Lucie County
See page 2 for instructions and additional paperwork required for specialty permits
1. Location/Site Address: O
2. Parcel -ID Number:
0MC _Ooo
Office Use
Section
I Townihi"
Ran a
Ma Page
IZoning
Land Use .
Initials
Only
i
3. Description of Projector Mork,Activity:
4. Owners Information
Name: R 0.1.f S J�vi s9n hlf Jevl Sei?
Address:%�O. Sv®nt ljTD�e R�
City: pt'erca State: p —
Zip: .31�9frj P6on� f 7�' % O i3t)
t 0,
6. Value of Construction: $ : ® oQ
eTV—'"Grim CP
5. Contractors Information
FL Reg/Cert #: k-C) 6363
County Cert#: 20 9 ?�
J
Business Name: Pq e_ E fe_d c l l2 .c
Phone Z 4'9" Fax T2 f —S$7/
OWNER'S' AFFIDAVIT: I certify ihif 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.
Rd dl '7a- �
PRINT QUALIFIERS/OWNERS NAME SIGNATURE OF QUALIFIER/OWNER
ATE OF FLORIDA, COUNTY OF - ACKNOWLE RE ME THIS �. DAY OF
20JBY WHO IS PERSON KNOWN TO FOR WHO HAS PRODUCED
IDENTIFICATION.
TITLE: NOTARY PUBLIC COMMISSION
St. Lucie County Specialty Permit Application rev. 8/25105 dmg
MV COMMISSION 8 pp q�
8. EXPIRES: Mar �47
EXPIRES.
ah 62011
�a�ers
9 `
NOTICE TO OWNER: FAILURE TO RECORD A NOTICE .OF COMMENCEMENT MA' ,''—< SULT 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 $5,000.
INSTRUCTIONS
Please,complete,,all information in the space provided. All information.must be printed (use black or blue ink
only) or typed. `Phis permit application is to be used only for those activities that are not otherwise included
under a primary building permit. This application may not be used for any activity that includes structural
alteration. The information to be provided with this application includes:'
1. Location/Site Address
2. Parcel ID Number
3. Description of Projec$ 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 activityis 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
❑ Sued:
Attach 2 plot plans, 2 copies of DCA letter and plans, 2 anchor specifications
❑.- ence
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 hispections can be scheduled by calling (772) 462-1261.
St. Lucie County Specialty Permit Application rev. 8M/05 drug