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Home My WebLink AboutSPECIALTY PERMIT APPLICATIONDate: '; ''j Fee Due:. O O I Receipt# 00. y Permit # 0 Planning & Development Services Building & Code Regulations Division SC YN�� 2300 Virginia Ave. Fort Pierce, FL 34982 S (772)462-1553 t. Lurie County SPECIALTY PERMIT APPLICATION ❑ Electrical Plumbing ❑ HVAC ❑ Fence ❑ Shed Demolition ❑ Gas . ❑ Siding See page 2 for instructions and additional paperwork required for specialty permits 1. Location/Site Address: 2. Parcel ID Number: I y" 160 ""Q 6 6 7— 006 Of"I Use Only Section Township Range Map Page Zoning an Use Initials 3. Complete Description of Project or Work: �Q S 4" Ot_- l-PW 5 d G J16 ^3 PJeD 4. Owners Information 5. Contractors Information Name: J q-n VgAeA)�e)f `f` FL Reg/Cert #: ('i:--C, Address: 6 / County Cert#: City:d� State: Business Name: n L Zip: � 4 `( C� Phone: 7?Z— IaU �? %9 71Phone: �7CJ" Z� ax: A.) 6. Value of Construction: $ S"II ew OWNERS 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 and zoning. �(T PRINT R OR CONTRACTORNAME GNATURE OWNER OR CONTRACTOR STATE OF LORIDA, COUNTY OF T\� �— C��• ACKNOWLEDGED BEFORE ME THIS CODAY OF t- , 20 N3'.16 WHO IS PERSONALLY KNOWN TO ME O O HAS PRODUC ,�4,•pY p- DEANNA GIVENS Notary Public - State of Florida AS IDENTIFICATION. *t My Comm. Expires Dec 16, 2016 2t, 4 y1 wog 6.vp°41 Commistiml3#• EE 858761 SIGNATURE OF NO ARY TYPE OR PRINT NAME OF NOT '"�� '�� Bonded Through National Notary Assn. COMMISSION NUMBER 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: FAILURI RECORD A NOTICE OF COMMENCEMENT," RESULT IN YOUR- PAYING'TWICE FOR IMPROV -NTS TO' YOUR PROPERTY. IF YOU INTENT s� 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 Projector 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'calcitlations. 2 sets of duct layouts for new system or -full replacement This, application can be,siibmifte�d to St. Lucie "County Building and Zoning, 2300 Virginia Avenue, Fort Pierce, ` Ft'3082. All', ""i t application's must be filled out completely before submission. No applications will be accepted for;,processingafter.4'30 P.M. •For,:assi$tance in completing this application, please -call (772) 462-1553, during regulaf'office ours (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 special arrangements and additional fee paid. Upon issuance of this permit, required inspections can be scheduled by calling (772) 462-1261.