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Home My WebLink AboutSUBMITTED PAPERSDate: Fee Due: Permit # Planning & Development Services Building & Code Regulations Division 2300 Virginia Ave. Fort Pierce, FL 34982 (772)462-1553 . /Vol, 000 f7 S SPECIALTY PERMIT APPLICATION SCANNED BY ❑ Electrical ❑ Plumbing ❑ HVAC ❑ Fence St, L_u�;g County ❑ Shed ,Demolition ❑ Gas ❑ Siding - Seepage 2 for instructions and additional paperwork required for specialty permits 5e ,iseo 12el �L 1. Location/Site Address: /0 2� JO`� y 7 2. Parcel ID Number: f l ;l C1 U ` oQ� /7 Office Use Only Section Township Range Map Page Zoning Land Use Initials 3. Complete Description of Projec�,or Work: 4. Owners Information 5. Contractors Information Name: A ® fir I/ � G Address: City: !�� i/9 State: Zip: 5- ` ; 77V Phone: 2� X P3-P 7 6. Value of Construction: $ O. 00 . . OWNER'S AFFIDAVIT: I OR CONTRACTOR STATE OF FLORIDA, COUNTY FL Reg/Cent #: C86 1,2- U % County Cert#: 2Z 7 22 Business Name:A14, ��i"f/� ��of .�I/� /"iC- Phone:%/�)d037I"J Fax: 77a 2322&/ lat all of the information contained in this application is correct and that all work will be done in ;e with all applicable laws regulating cons n z SIGN OF OWNtR O CONTRACTOR ACKNOWLEDGED BEFORE ME THIS _ DAY OF WHO IS PERSONAL4�KNOWN> ME OR WHO AS NTIFICATION�,'�^��/,�� SIGNATURE 0 OTARY COMMISSION NUMBER PRODUCED TYPE OR PRINT NA&M OF NOTARY 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 $7500.00 Revised 04/26/2010 gti. ri AUDREY & HUMPHREY r MY COMMISSION # EE 061159 ;' ;�'iz. edd(Bonded Notary Public Underwriters NOTICE TO OWNER: FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENT% 0 YOUR PROPERTY. IF YOU INTEND TO 'P"TAIN FINANCING, CONSULT WITH YOUR LENDERv, AN ATTORNEY BEFORE RECORDING YOUR I �, CE OF COMMENCEMENT. EXEMPT: A/C -HEAT REPLACEMENT wrm CONTRACT UNDER $z:;"J. 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 Dumber 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 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 ductlayouts 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 P", 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. Planning.& Development Services Building & Code Regulation Division. 2300 Virginia Avenue Fort Pierce; FL. 34982 Phone:(772)462-2172 Fax:(772)462-6443 January 02, 2014 ASBESTOS NOTICE Asbestos Notice to Contractor ADAM SMITH BOBCAT SERVICE INC ADAM SMITH 661 NE SPENCER ST JENSEN BEACH, FL 34957 RE: Building Permit Number 1401-0007 It is your responsibility to comply with the provisions of Section 469.003, Florida Statutes and to notify the Department of Environmental Protection of any intentions to remove asbestos when applicable in accordance with state and federal law. jell, Signature /—; -- /Z/ Date 1 /2/2014 11:47:31 AM