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Home My WebLink AboutSUBMITTED PAPERSDate: �Recef1" Permit # jq 0 D. j � Initials: �(�l PLANNING AND DEVELOPMENT SERVICES DEPARTMENT - Building and Code Regulations Division SCA 0 2300 Virginia Ave. B y ' Fort Pierce, FL 34982 St. (772)462-1553 u�ie County SPECIALTY PERMIT APPLICATION ❑ Electrical Plumbing ❑ HVAC .❑ Fence ❑ Commercial Irrigation ❑ Shed ❑ Demolition ❑ Gas ❑ Siding Seepage 2 for instructions and additional paperwork required for specialty permits / c ^ �(' 9ff— 1. Location/Site Address: r L3 / % V Q Z - Y` Y' i " �'� i QYC e �� v ` 1 2. Parcel ID Number: c� Oat 3 ' 0 O 0 — 3. Complete Description of Proposed Work: / rg� 4. f/ 0 Owners Information 5. Contractors Information Name:1 Address �c�� 1r"6 ' FL Reg/Cert #: County Cert#: 7 7 city: W �� 'Ug' State: �i• ?usiness Name: "!2:} Zip: \J � one:a7 ! ' �2-02d (,_ Phone: ��`� • � � � g' t 6. Value of Construction: $ .�- �' c�) Email: OWNER'S AFFIDAVIT: I certify that all of the information contained in this application is correct and that all work will be done in cfi7ance ith all applicablregulating e Ws co o zoning. P O R Olk CONTRACTOR N �SIGNA O WNER OR C0)rRACTOR STATE OF FLORIDA, COUNTY OF�( _ A ACKNOWLEDGED BEFORE ME THIS . DAY OF 20,_, BY , - - - -- — - -- - -O HAS PRODUC ° 1(ic6f j A. KING 11 MY cot. 7N # EE 877241 a€ EXPil;- ..•Aay 4, 2017 Banded Thro Nn&y Public Underwriters 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 11YJ 1 AUl.11V1VJ _ Please complete all informatic;,.r the space provided. Ali information i ;t be printed (use black or blue ink only) or typed. This permit apL,,, ition 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 pted 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 be performed after 3: 00 PM without specidt'dkkangements'and additional fee paid. Upon issuance of this permit, required inspections can be scheduled by calling (772) 462-1261. I��(M,77a rp'�ij y�.rwT'�J�i?;5!;F+'r1nr541Tr�^.^r.(„=rt�s+a. c,��Clht� -..rR COMM ST. LUCIE'COUNTY UT'IIITIES - A. BOXID2SFT ?IERCE . f SEWER . RES METER SZ. NAME14 Y., . ! i RR ACCT. # / SECURITY DEP SERVICE ADDRESS SERVICE FEE SAME DAY FEE I SUBDIVISION f'Y1r i` 'itZ 'e ic OVERTIME FEE I I L METER INSTALL. BILLING ADDRESS1>` CFC/WATER FP CFC PIIO ? { 1 i IN CLOS CFC/SEWER y ! I This 'a icat�on gr GUAR. REV3`�'thorizes t(�e �Utiht� Ito render w, services to remise ess� cubed above m accordance wi the Utili LATERAL rules.and regulations, which by reference are, madei part of I'Ithis contra the Utility promptly for such services in accordance with ttie e'stalili: TATAL CUSTOMERS DEPOSITS ARE NO NEGOTIABLE•' OR 1 RANSFE CUSTOMER V SOCIAL SEC/ SIGNATURE1i/' 4 FED ID .✓' -. /( NAME OF SPOUSE I SPOUSE SOCIAL SEC.. 1 OFFICE USE ONLY .] - DATE RECEIVED �' ill ! CASH . CHK # S f�; `l ` .r . ( RECEIVED BYY L I i er and/or sewage disposal es present or future rates, t Applicant agrees to pay kdd rules and regulations. .ABLE!