HomeMy WebLinkAboutSUBMITTED PAPERSi
Date:la 5 13 Fee'DUe: -)13 Receipt#:rmit# 1��a-o�63
St. Lucie County Building & Zoning SC,GN
2300.Virginia Avenue Ft. Pierce, FL 34982-5652 St. QY �r
Te1.561-462-1553
SPECIALTY PERMIT APPLICATION ty
❑ Electrical ❑ Plumbing ❑ HVAC . ❑ Fence
❑ Shed ❑ Demolition AGas ❑ Siding
Seepage 2 for instructions and additional paperwork required for specialty permits
1. Location/Site Address:
Co CO PI U M
2. Parcel -ID Number: (DO I — C> 0110 " OOD
Office Use
I Section
Townshi"
Range
I Map Page
I Zoning
Land Use
Initials
Only
3. Description ,of Project or Work.Activity:
4 A < (l t I C -fin 2 0 K: UJ .
4. Owners Information
Name: A01leac- Tutu
Address: IJ5o3 N.LJ. Coto Plea. CA.
City: Jr4 State: '�(
Zip: 3 `ytw Phonne:
6. Value of Construction: $ 100o:00
P. I A N (G . 1 SIX
t'r 14 Pr,4" woalt-QP.
5. Contractors Information
FL Reg/Cart #: - O &aM
County Cert#: 21 o (. `l
Business Name: 1y\AZ4.cl'> Co 1'.400 kL)z
Phone I D-1 R0 Fax v). 4) - SOL(&
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.
PRINT QUALIFIERS/OWNERS NAMESIGNATURE OF QUALIFIER/OWNER
t�J
STATE OF FLORIDA, COUNTY OF / K � ACKNOWLEDGED BEFORE ME THIS DAY OF
20 /3 BY �u ���t'rso r� WHO 1 It�9AiALLA KNWN TO ME OR WHO HAS PRODUCED
/ AS IDENTIFICATION.
v lz:��h e_ C�z 11 4--f (seal)
SIG ATU O NOTARY TYPE OR PRINT NAME OF NOTARY
?TLE: NOTARY PUBLIC COMMISSION NUMBER G "
NER
COMM18®10f1 aE01347
*e my CO M119110h tX069 12-10=2016
-* .. N Wflti®tm §Uf61'y
Bond®d 1Nteug
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1.111
St. Lucie County Specialty Permit Application rev. 8/25/05 dmg
NOTICE TO OWNER: FAILURE `'; o RECORD A &OOC$ OF COMMENCEMENT`N:.=:,_-,'RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FIN'T
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. 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 the
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 number
and the name of the business doing the' -work.
'6. Value of Construction 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"'lot plans showing location offence height offence 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.:.Ernergency .electric service, change out inspections will not be performed after 3: 00 PM without
special arrangements and additional fee paid.
'U;pon;;issuance.of this permit;`regiiired inspections can be scheduled by calling (772) 462-1261.
St. Lucie County Specialty Permit Application rev. 8/25/05 dmg