HomeMy WebLinkAboutSPECIALTY PERMIT APPLICATIONPlanning & Development Services
Building & Code Regulations Division
2300 Virginia Ave.
Fort Pierce, FL 34982
(772)462-1553 Fax 462-1578
SPECIALTY PERMIT APPLICATION
❑ Electrical ❑ Plumbing r CTHVA ElFence
❑ Shed* ElDemolitlo as ❑ Siding
Seepage 2 for instructions and additional paperwork required for specialty permits
1<. Location/Site Address: 135 CAMINO DELRIO , PORT SAINT LUCIE, FL. 34982
3427-111-0002-000--5--
2. Parcel ID Number:
3. Complete Description of Project or Work:
4. Owners Information
DARCY THOAMS
Name:
Address: 135 CAMINO DELRIO
PORT SAINT LUCIE FLORIDA
City: State:
SCE
St 4U eytiFv
C
olllwy
Vvi
AIR CONDITIONING REPLACEMENT. LIKE FOR LIKE 7.5 HEATER
5. Contractors Information
FL Reg/Cert #:
34952 78U i!)482U
Zip: Phone:
6. Value of Construction: $
OWNER'S
County Cert#:
Business Name:
7726264629
Phone:
CAC058461
A/C DOCTORS INC
7726075700
Fax:
f information contained in this application is correct and that all work will be done in
applicable laws regulating construction and zoning.
WRIN�ER OR CONTRACTOR E SIGNATURE OF OWNER OR CONTRACTOR
STATE OF FLORIDA, COUNTY OF
ACKNOWLEDGED BEFORE ME THIS DAY OF
,----WHO IS PERSONALLY KNOWN TOM OR WHO HAS PI
COMMISSION NUMBER
D6A� MILDNE
T NAME OF NOTARY :•a kav PUB`'�'z Notary Public -State of Florida
• ; : • 5 My Comm. Expires Mar 22, 2017
Commission # EE 877571
�� �0�•• Bonded Through National Notary Assn.
*ALL RESIDENTIAL AND NONRESIDENTIAL STRUCTURES ARE REQURIED TO MEET THE FLOOD ZONE
ELEVATION OR 18 INCHES ABOVE THE CROWN OF THE ROAD, WHICHEVER IS APPLICABLE. (see instructions on
reverse side of this sheet)
Revised 03/18/2014