HomeMy WebLinkAboutSPECIALTY PERMIT APPLICATIONDate:I iTWee Due: Recei t# rmit #
St. Lucie County Building & Zoning
2300 Virginia Avenue Ft. Pierce, FL 34982-5652
Tel. .462-1553 eYN�Q
SPECIALTY PERMIT APPLICATION
Unl�:
CO Electrical ❑ Plumbing ❑ HVAC ❑ Fence
❑ Shed ❑ Demolition ❑ Gas ❑ Siding
Seepage 2 for instructions and additional paperwork required for specialty permits
1
1. Location/Site Address:y C) V
2. Parcel ID Number: 1 0 `7 %�
Office Use
Section
Townshi
Range
Map Page
Zoning
Land Use
Initials
Only
3. Description of Project or Work Activity: 42w✓ eo w CL- �I
4. Owners Information _
Name: SZ od 4 �ultd"S hC
Address: �1n o 3 A-10 �v✓�� f¢1/4-
City: G✓c,* State: =(,
Zip: It C, Phone:
6. Value of Construction: S . C-00 cOD
5. Contractors Information
FL Reg/Cert #: / 3 vo f C/S%
County Cert#:� C
Business Name: G' 13 e"s 'QC' / J�i/(C-C � �e
Phone 7? 2 • 2,f&-9"F(ax ? -2 z- 2-9-� S7 G 6
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
PRINT QUALIFIERS/OWNERS NAME SIGNATURE OF QUALIFIER/OWNER
STATE OF FLORIDA, COUNTY
0 L^LJS—ate ACKNOWLEDGED BEFORE ME THIS DAY OF
20 Y r C' (]O 1S PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED
sl�Cq! E CATION.
C (sea))
SIG T OF NOTA Y TYPE OR PR N NAME OF OTAR
TITLE: NOTA Y PUBLIC COMMISSION NUMBER w„
.a•� °yes ANGELA M. HUFF
My COMtJgMON # EE CIOF20
EXPIRES: April 12, 2015
%S pP� q.•' Bonded Thru Notary Public Urdemvnte .;
St. Lucie County Specialty Permit Application rev. 8/25/05 dmg
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 $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 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 beforesubmission. 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),'1Vlonday through Friday.
NOTE: Emergency electric service change out inspections will not be 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
St. Lucie County Specialty Permit Application rev. 8/25/05 dmg