HomeMy WebLinkAboutSPECIALTY PERMIT APPLICATIONt
Date: Fee Due:' Recei t# 12 aea Permit #
r l Planning & Development Services No —o-� I /
Building & Code Regulations Division
2300 Virginia Ave.
Fort Pierce, FL 34982C�
(772)462-1553
Y �
SPECIALTY PERMIT APPLICATION Coin
❑ Electrical ,T`lumbing ❑ HVAC ❑ Fence
❑ Shed ❑ Demolition ❑ Gas ❑ Siding
Seepage 2 for instructions and additional paperwo/r�k required for specialty permits
1. Locatiorf/Siit Add ss: �(� q� S
2. Parcel ID Nmn 7e.2-oo /.z & D o 6
Office Use
Only
Section
Township
Range
Map Page
Zoning
Land Use
Initials
3. Complete Description of Project or
4. Owners
Name:
Address:
City:
Zip: ( 7yu Phone:
6. Value of Construction: $
5. Contractors Information
Reg/Cert #: G�G /GiZ la
County Cert#:
Business Name: Ll
Phone?'&/ W % Fax: 772 —3z5 5 3
OWNERS IDAVIT: I certify that all of the ' ormation contained in
compliance with al p ' ble laws regulat'
Yi �Lo i� cwt�
PRINT PWNER OR CONTRACTOR NA SIGNAT
STATE OF FLORIDA, COUNTY OF 0C�
ACKNOWLEDGED BEFORE ME THIS / V DAY OF 20
WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED
AS ID NT ATION. `
- Ku�-
SIGNATURE OF NOTARY TYPEORPRII
COMNESSION NUMBER
OF OWNER
L
is correct and that all work will be done in
,zoning.
u lei 1eu011eN q noj41ppapuog
B 33 # uotssiwul��'lI ; o 'd'•,
ARY L10i 'ZZ jeW sajidx3 •11111J00 Aw ='•� *~.
epiJol j !o alelS - 011gnd Ale J e,"a`,o=`;
MIN NMV0 =
NOTICE TO OWNER: FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
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
f/Le 0 P11
NOTICE TO OWNER: FAILURES RECORD A NOTICE OF COMMENCEMENT Niki"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 $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 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.