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HomeMy WebLinkAboutSPECIALTY PERMIT APPLICATIONY./©.0 Fee D Permit # , 0-', Electrical ❑ Shed Planning & Development Services Building & Code Regulations Division 2300 Virginia Ave. Fort Pierce, FL 34982 (772)462-1553 SCANNED B 1' St. Lucie County SPECIALTY PERMIT APPLICATION ❑ Plumbing ❑ HVAC ❑ Fence ❑ Demolition ❑ Gas ❑ Siding Seepage 2 for inssttruedons and addidoonnal paperwork required for specialty pernuts 1. Location/Site Address: Cry 9 C c) " e l2 e D 2. -Parcel ID Number: A k)9 _3 5- d, n6d J., ©n Office Use Only Section Township Range Map Page Zoning Land Use Initials 3. Complete Descript)on of Project or I S'fA/1 fuew1 S 1'-4 actors Information Name:(i ( t7O�/ /�(r✓ Address: 1 d� G— TA t (r 4 City: LaA ft UV-r State: _ Zip: �� Ip Phone: / 6. Value of Construction: $ !00 0 'o FL Reg/Cert #: Go(5oC�472 +— County Cert#: 3 47 Business Name: 14� )J A. Phone: Fax: �� 0 1y— `7d�� OWNER'S AFFIDAVIT: I certify that all of the information contained in this appin i ect and t compliance with all applicable laws regulating constru�1� ning. PRINT OWNER OR CONTRACTOR NA)q SIGNAT OF OWNER OR CONTRACTO] IL 9- STATE OF FLORIDA, COUNTY ACKNOWLEDGED BEFORE ME THIS _ DAY O 0 � BY w WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED all work will be done in AS NTIFICATION. V L� D O, � �• �� • S NATURE OTARY YPE 41yTABNOTARY COMMISSION NUMBER / . a`p J . lz (seal) 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 .%,m a.,, Y .. AUDRE'6 B. HUMPHREY Revised 04/26/2010 $ MY COMMISSION I E: 061159 = EXPIRES: March 6, 20 i 5 N. Bonded Thru Notary Public iJnde `:wi;e s NOTICE TO OWNER: FAILURE tECORD A NOTICE OF COMMENCEMENT Mr:a- tESULT IN YOUR PAYING TWICE FOR R"ROVEMENTS 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 WrM 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 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 Fork Activity t 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, 1 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 deteririvne 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 similaf 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 0 HVA(C Attach 2, residential energy studies, 2 *man ual i 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 befilled out completely before submissions 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), 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.