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Home My WebLink AboutSUBMITTED PAPERSDate: J I of 11 L_t:Fee Due: J.,_— T . I Receipt# 3L1: Planning & Development Services Building & Code Regulations Division 2300 Virginia Ave. Fort Pierce, FL 34982 (772)462-1553 SPECIALTY PERMIT APPLICATION ❑ Electrical ❑ Plumbing ❑ HVAC ❑ Fence ❑ Shed .*r Demolition ❑ Gas ❑ Siding Seepage 2 for instructions and additional paperwork required for specialty permits 1. Location/Site Address: W /G AS %�1,,c/ J c-,4g,l Re4c4 FG 3 5 2. Parcel ID Number: 1-15-0,?- - 5-0% - 0,215--0-00 SCANNED BY St, Lucie County. Office Use Only Section Township 1 Range Map Page Zoning Land Use Initials 0 3. Complete esc�r7iption of Project or Work: 0'/ 5-- $i lk jai r q#Aon ,7G1 4. Owners Information yy� ` 5. Contractors Information Name: Ph�/gip If, d`/'��y l / 0!'s'i_f Address: HBO City: 5'a C1 State: FL Reg/Cent #: County Cert#: 2% ;7,73 Business Name: 414W � �� 90� f J-VG ;nc . Zip: 06870 Phone: ) 3 9Y ),7.2- Phone:77Z,-7/0-?7�5Fax: 77Z 6. Value of Construction: $ IQ 00 OWNER'S AFFIDAVIT: I certify that all of the information contained in this application is correct and at all work will be done in ' compliance with all applicable laws regulating cons 0 d zon,�j PRINT OWNER OR CONTRACTOR NAME SIGNATURE OF OWNER OR CONTRACTOR STATE OF FLORIDA, COUNTY OF Luwc ikc) ACKNOWLEDGED BEFORE M THIS DAY OF 20� B E Y ERSONALLY KNOWN OR/WHO HAS PRODUC D ENTiFICATI N. '(� - — — SIGNATURE O OTARY TYPE R PRIRT NJ OF NMVcommiSSiON EEaB3530O EXPIRES: April COMSSION NUMBER Bonded Thru Notary ublic Un derwriters nderwriters 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: FAILUR 't'�,i RECORD A NOTICE OF CONIMENCEMENT rfs"7 RESULT IN YOUR PAYING TWICE FOR IM[PROV ;NTS TO YOUR PROPERTY. IF YOU INTEN1 OBTAIN FINANCING, CONSULT WITH YOUR LtrgvER OR AN ATTORNEY BEFORE RECORDING Y.':,W:: NOTICE OF COMN[ENCEMENT. 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 prknary building permk. This application may not be used for any activity that ineludeq q1tructural 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 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 before submission. No applications will be. accepted for processing after' 4:30 P.M. For assistance in completing this application, please call (772) -462 1353, durmg regularoffice-hours (8:00"AA4-- 5-OD-PM), Monday tlWUIu -Vtlda NOTE. Emergency electric service change out inspections will not he 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. E Planning&. Development Services Building & Code Regulation Division 2300 Virginia Avenue Fort Pierce, FL. _34982 Phone:(772)4624172 Fax:(772)462-6443 May 21, 2013 ASBESTOS NOTICE Asbestos Notice to Contractor ADAM SMITH BOBCAT SERVICE INC ADAM SMITH 77 SW RIVERWAY BLVD PALM CITY, FL 34990 RE: Building Permit Number 1305-0313 It is your responsibility to comply with the provisions of Section 469.003, Florida Statutes and to notify the Department of Environmental Protection of any intentions to remove asbestos when applicable in accordance with state and federal law. Signature '�-,2-1 - 1'7 Date 5/21 /2013 2:16:15 PM