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HomeMy WebLinkAboutSPECIALTY PERMIT APPLICATIONPlanning & Development Services Building & Code Regulations Division 2300 Virginia Ave. Fort Pierce, FL 34982 (772)462-1553 SPECIALTY PERMIT APPLICATION ❑ Electrical ❑ Plumbing Z RVAC ❑ Fence ❑ Shed ❑ Demolition ❑ Gas ❑ Siding Seepage 2jorInstrueftous and addili/nail-pap�erworkreeq�ufredjorsp�t3'pMais 1. Location/Site Address: 31 W n Asr-4 19 n C 03 2. Parcel ID Number: 3. 4. (005`7 SCANNED BY St. Lucie County office Use Only Section Towawbip Range Map Page Zoning Ld Use - an Initial+ Owneorma '0 5. Contractors Information Name - Address: Address: 3100 City: , /�,f (�40 (Le- State: r_ Zip: 3�,lQ4q 1 -Phone: 6. Value of Construction: S W s 1 with all applicable FLReWCert#: IAQ�I1ko 4V County Cert#: 8�O Business Name: to - lam. ,ty, lei �nCQ Phone: agm Fax: 1_[ w.cJ� construction STATE OF FLORIDA. COUNTY OF IV c7iuiae ACKNOWLEDGED BEFORE ME THIS _ DAY OF 20\1 BY SA WHOIS PERSONALLY KNOWN TO ME ✓ OR WHOHAS PRODUCED IDENTIFICATIO . COM&USSIONNUbMEfl IEGC)& lqa. correct V. ( G,on 0 TYPE OR PRINT brUF NO Y A NOTICE TO OWNER: FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR PAPROVENIENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF. COMMENCEMENT. EXEMPT: A/GREAT REPLACEMENT WITH CONTRACT UNDER $5,000. 07/05/2011 12:56 777' 73053 SEACOAST AC, - F PAGE 02 C(7 JNTY ❑ Electrical I] Shed Planning & Development Services Building & Code Regulations Division 230o VtrdWx Ave. Fort Hem FL 34982 (713)40-1553 SPECIALTY PERMIT APPLICATION ❑ Plumbing M VAC 0 Fence ❑ Demolition 13 Gas ❑ Siding SeepsgeZfor61sfmdions axdaddUlmrnlpaperwor�li regrrfi�edforsp¢elof(pPrl+pi� 1. Loesdou/$ite Address: 2. P2md m Nmnber: 3. 4. Ow Name. Address: 5. Costraetors Information City: liCe _ stater Zip: 3 `t Phone. QI , 6. Wuc of Construction: S W all applicable laws FL Rgprert #: County Cert#: BusineZbouax- Construction correct ACl33iOWLFpp®BBkY1R8MSTHIS - DAYOF�20�,HY �✓C7� Y ±V • `V VM013 PBSONALLYENOWN TOmEi ✓ ORwHO1rASpROD id m D1ENi'¢SCAT[O �II m.-�,,_o> r'- SIGNA C T7tPB OR PR1NC u N Y Ci p COaeusasaaMSER fEa'a � 20 NOTICE 10 OSPMM FATLORE To RECORD A NOTICE OF COMMENCEMM MAY RESULT IN YOUR PAYING TWICE FOR FHPROVEB NTS TO YOUR PROPERTY. IF YOU EVIRND TO OHI'AIN FINANCW% CONSULT Vffm YOUR IMMER OR AN ATTOHNBY DEFORR RF.00B.DINGYOIIRNOnCE UF4OMWNCEMM. EXEMPP7 A/CmKUr REFLACErriENT WITH CONTRACT UNDER $5000.