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Home My WebLink AboutSPECIALTY PERMIT APPLICATIONDate: I Fee Due: TReceipt# „, Permit # JY qeR —00'1-q� Planning P & Development Services I Building & Code Regulations Division 2300 Virginia Ave. Fort Pierce, FL 34982 (772)462-1553 SPECIALTY PERMIT APPLICATION S R1 Electrical ❑ Plumbing ❑ HVAC ❑ Fence St cgY%ED ❑ Shed ❑ Demolition El Gas ❑ Siding �Qcie COUnty See page 2 for instructions and additional paperwork requiredfor specialty permits 1. Location/Site Address: 1 3 a 3 1 N hJ [4c L - ^' 4iL 96d 2. Parcel ID Number: (4 42-.�- - to () i - UO ( Z. - 00(-)- g Office Use Only Section Township Range Map Page Zoning Land Use Initials 3. Complete Description of Project or Work: W� W 4. Owners Information 5. Contractors Information Name: 2a Lerf A- A I Ee-n 1<, I'( c FL Reg/Cert #: Ec ( 3 Oos l -7 Address: o� (� w 1 q I�ri S / 1'1/`� .S County Cert#: S, City: 44S y/. e State: A Business Name: �I,f•eV1J+2 -ElIL Zip: 3 s U l - (f 4 SO Phone: 3 3 6 - ? UUO Phone: Fax: `t (o 6 S O 6. Value of Construction: $ 3,5 D 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 construdi n and zoning. �r � c. �•�`iv�� v��e�, V Cam.. PRINT OWNER OR CONTRACTOR NAME SIGNATURE OF OWNER OR CONTRACTOR STATE OF FLORIDA, COUNTY OF L • L ti C.; L ACKNOWLEDGED BEFORE ME THIS SDAY OF Se ode r" bey , 20 I y , BY Er Pc Letwxneg,,., r WHO IS PERSONALLY KNOWN TOME "'-OR WHO HAS PRODUCED AS IDENTIFICATION. AAj VO& SIGNATURE OF NOTARY COMMISSION NUMBER Ff 09 G 4l7 3 Ckr, s woo 11-eK TYPE OR PRINT NAME OFfNOTARY 398-0153 CHRIS L WOOLLEY MY (' 0MMISSION #FF096403 EXPIRES February 26, 2018 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 04/26/2010 NOTICE TO OWNER: FAILURE TO RECORD A NOTICE OF COMMENCEMENT N`" RESULT IN YOUR PAYING TWICE FOR I!M?ROVEN, 'S TO YOUR PROPERTY. IF YOU INTENIz )OBTAIN FINANCING, CONSULT WITH _ YOUR LEN_',� �/OR AN ATTORNEY BEFORE RECORDING YObf,':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 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, a - -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) 4624553" our ng reguYar-office hours (8:00 AM - 5:00 PM), Monday through Friday. �- - -° "NO•TE:�'Emer.'gencyaelectric 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.