HomeMy WebLinkAboutSPECIALTY PERMIT APPLICATIONDat a Fee Du,j� _M Recei t# Permit #
Planning & Development Services
= Building & Code Regulations Division
- 2300 Virginia Ave.
Fort Pierce, FL 34982
- (772)462-1553
SPECIALTY PERMIT APPLICATION
ElS Electrical ❑ Plumbing ❑ HVAC ❑ Fence SC� cNEO
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❑ Shed Demolition ❑ Gas ❑ Siding Cpcl
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See page 2 jor instructions and additional paperwork required jorspecialry permits 1. Location/Site Address: v 5.�� �jrn' /y JC i s' L �' J Z) rL J /
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2. Parcel ID / Number: I `5 Dc�j / 6'C) 6 O,3
Office Use
Only1.22
section
Tosss,sbip
Range
Map Page
Zoning
Land Use
Initials
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3. Complete Description of Project or Work: P P yv u I4t',9yi 44o U St%
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4. Owners Information I 5. Contractors Information
Q.. Name: 16tC ; S C h rIc' 4r— FL Reg/Cert #:
Address: 305-L r1 t nn CT15 ' E . . County Cert#:
• C BC I� 9S
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City: 264 51 •Lu&,'e . State: El Business Name: �J P 15tb n CUS�m Conf re K L°�/1$ / ,
Zip: 3 (qiq Phone: % % -y - yob Phone: 957'��9'�u�Fas:
6. Value of Construction: $
OWNER'S AFFIDAVIT: I certify that all of the information contained in this application is wrr a and that all work will be done in
compliance with all applicable laws regulat c nstruction and zoo'
X IV t Scln>1i�cidr
PRINTOWNER RCONTRACTORNACMM S NA OFO OR CONTRACTOR
STATE OF FLORIDA, COUNTY OF * t g ll&0Sq �--
ACKNOWLEDGED BEFORE THIS_ DAY,OF �1�UJ�U .20 BY
WHO IS PERSONALLY KNOWN TO
AS R)EwtFi0ATi0N. D)- 4t i
(seal)
COMMISSION
NOTICETOOWNER'. FAILURE MY
OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR
IMPROVE PROPERTY. IF YOU INTEND To OBTAIN FINANCING, CONSULT WITH YOUR
LENDER OR AN Y BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
EXEMPT: A/C -HEAT REPLACEMENT W1TII CONTRACT UNDER S7590.00
Revised 0426/2010
'• .NOTICE TO OWNER; . FAILURE T ` SCORD A NOTICE OF commENCEDpRIT MAY SILT IN YOUR PAXI@IG TWICE FOR
WROVEMnNio TO YOUR PROPERTY. IF YOU INTEND TC` MAIN FINANCING, CONSULT wiTH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDINdYOUR NOTICE OF COMvIENCEMENT.
Ex61YIPT: 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
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
; ;y '�•'. niunber•and the'natne of theliusiness doing the
work.
6. Value of Construction Indicate the total value of the work to take place,:;
Total cost of construction includes all curreni-iretail
material and labor costs associated'*ith the e .
--building/construction activity. Construction value is
used to determine the permit fee. St. Lucie County
reserves the right to question and/onmodify. 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 Attacli 2 copies of manufactures specifications
❑ liVAC Attach 2 residential energy studies, 2 manual J.calculations: 2 sets of duct layouts for
we* 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 submissioii;;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 P1b1), 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