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HomeMy WebLinkAboutSUBMITTED PAPERSF PLANNING AND D VELO"WRVICES DEPARTMENT t—()fl J Building g and Code Regulations Division 2300 Virginia Ave. Fort Pierce, FL 34982 SCANNED (772)462-1553 B Y St, Lucie Count SPECIALTY PERMIT APPLICATION ❑ Electrical ❑ Plumbing ❑ HVAC � Fence ❑ Commercial Irrigation ❑ Shed ❑ Demolition ❑ Gas ❑ Siding See page 2 for instructions and additional paperwork required for specialty permits 1. Location/Site Address: / 0 6 A clkwi/ R/eyne-, 2. Parcel ID Number: 3q 02- (009 D `000r 3. Complete Description of Proposed Work: 1, ✓) -;>1 rP i'D l (I) SFf- Walk rr} o LT S t.S e IZ Fr W / qq q4e- 4. Owners Information 5. Contractors Information Name: inS�oa�e �' FL Reg/Cert #: Cae —e - Address 5106 �I 6 C //-a � t County Cert#: City: PT: PIE!VZX State: % Business Name: A L,04 'S'c�e ,�mod0�un pT strippi- av--,ne. al�14 mince Cc, fre- ar (tv e (fo C's+ Zip: Sq 91q Z Phone: q� ? `rl Phone: 2-U (-,j'-( o 3 Fax: q I0 1 -1 2G I 6. Value of Construction: $ / r Email: � i ) C tV"" 51- OWNER'S AFFIDAVIT: I certify that all of the information contained in this application is correct and that all w4 v&l I d in compliance with all applicable laws regulating cons ti n and zoning. — 1 �P PN PRINT OWNER OR CONTRACTOR NAMEi SIGN bF'OWIqER OR MNTRACTORZO ?c STATE OF FLORIDA, COUNTY OF �} L e r ACKNOWLEDGED BEFORE ME THIS DAY OF K `C" 1" , 20 BY WHO IS PERSONALLY KNOWN TO ME ( ) OR WHO HAS PRODUCED AS NTIF ATIO . ` -ec 9163 X. j; CATHERME` SAPP (�11 1 vu 5��' ' I �''�WfISSION 0 EE170711 SI NO � � � TYPE OR PRINT NAME OF NOTARY ExPIt�E3 Fabeuery 1!!, ?©te COMMISSION NUMBER EP 1 � VMW 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 01/03/2014 Flease complete all intormation in the space provided. All information must be printed (use black or blue ink only) or typed. This permit appl .on is to be used only for those activit' ':hat are not otherwise included under a primary building permit. i nis application may not be used for an, tivity that includes structural alteration. The information to be provided with this application includes: 1. Location/Site Address 2. Parcel ID Number 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 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: 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, required inspections can be scheduled by calling (772) 462-1261. - ------------ 'A_q �-{Jl soh