HomeMy WebLinkAboutSPECIALTY PERMIT APPLICATIONx ee sue:
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Planning & Development Services
Building & Code Regulations Division
2300 Virginia Ave. S'
Fort Pierce, FL 34982
(772)462-1553 .
SPECIALTY PERMIT APPLICATION
❑ Electrical Gkl." Iumbing ❑ HVAC ❑ Pence
❑ Shed ❑ Demolition 0 Gas ❑ Siding
See page 2 for instructions and additional paperwork required for specialty permits
1. Location/Site Address: ef�� Z 6' / -6- �4 /%.c
2. Parcel ID Number: 2'2 0 a? I/ D D O
Lifffca Use
Only
Section
Township
Range
Map Page
Zoning
Land Use
In
3. Complete (Description of Project or Work: �-„ 1 � & z /�
r/✓4 %2 r /`� Q r S i r. 7` 9Iff' Z /ve a .� of /'ii� "w� 7'4 �• /�r
4. Owners Information 5. Contractors Information
Name: t�v0.0 FL Reg/Cert #:
Address: 10 31 Z C/'-pS 4 V /�/ c County Cert#:
City: State: Business Name: 7h & !, h c w,) r z
Zip: 2 Y 9&C Phone: 772_,g2 _ V.7 Phone:--�72 ?26 7272- Fax:
6. Value of Construction:
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 zoning.
v�'Gt' Jay /CX.%ic
PRINT OWNER OR CONTRACTOIRNAME � SIGN TURF OF OWNER OR CONTRA
.STATE OF FLORIDA, COUNTY OF CA�
ACKNOWLEDGED BEFORE ME THIS DAY OF 20t�711``BY
WHO IS PERSONALLY KNOWNTO ME OR WHO HAS PRODUCED \r)z y
ENfIFICATION.'C� -A _
(seal)
A URE OF OTARY T E 0 PRINT AME OF NOTARY
COMMISSION NUMBER
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
NOTICE TO OWNER: FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR
IMPR�" ;vIENTS TO YOUR PROPERTY. IF YOU INT TO OBTAIN FINANCING, CONSULT wrrH
t YOUR 111DER OR AN ATTORNEY BEFORE RECORDIN(, )UR NOTICE OF}COMNIENCEMENT.
EXEMPT: A/C -HEAT REPLACEMENT WITH CONTRACT 'ui�f ER $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
2. Parcel 11D 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 duct layouts for
new system or full replacement'
This application can be submitted to St. Lucie d6unfy 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 this4pplkation 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 he performed after 3: 00 PM without
special arrangements and additional fee paid.
Upon issuance of this permit, requited inspections can be scheduled by calling (772) 462-1261.