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Home My WebLink AboutSUBMITTED PAPERSI)ate:'I ' H — I . -) I Fee Planning & Dev"elopment-Services Building & Code Regulations Division 2300 Virginia Ave. Fort Pierce, FL 34982 (772)462-1553 Permit # I "�b9 SPECIALTY PERMIT APPLICATION ❑ Electrical ❑ Plumbing ❑ HVAC ❑ Fence SCANNED ❑ Shed 19 Demolition ❑ Gas ❑ Siding St Lli 8y Cie hr Seepage 2 for instructions and additional paperwork required for specialty permits 1. Location/Site Address:\45;;i a _!�; _ Q " * " / ' �0 2. Parcel ID Number: ';� Q 3l'o 3y / 606 1 O C615 Office Use Only Section Township Range Map Page Zoning Land Use Initials 3. Complete Description of Project or Work: 4. Owners Information n — Name: Address: 5. Contractors Information FL Reg/Cert #: County Cert#: City: VeQ> 6"Glo State: sr, r Business Name: 14G. Sq Zip: ( Phone: '�� 7 0 hh nef---D 1 Fax: 6. Value of Construction: $ OWNER'S AFFIDAVIT: I certify that all of the information c compliance with all applicable laws ion is correct and that all work will be done in and zoning. PRINT OWNER OR CONTRA IL_ ME SIGNATURE OF OWNER OR CONTRACTOR STATE OF FLORIDA, COUNTY OF ACKNOWLEDGED BEFORE ME THIS AY OF 20BY &JV" WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED AS IDE CATION. l Ian DAWN MILONE .` ,tiP et�4 `.�� ; Notary(�ic -State of Fforlda F OTARY TYPE OR PRINT NAME OF NOTARY My Comm. Expires Mar 22, 2017 V Commission � EE 877571 COMMISSION NUMBER ; �F r ° �'� Bonded Through National Notary Assn. NOTICE TO OWNER: FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY IiS LT IN 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 RECORD A NOTICE OF COMMENCEMENT RESULT IN YOUR PAYING TV IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSU 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 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 Attacli-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, .AW z ; >; 3982. All permit applications must be filled out completely before submission. No applications will be rtl,a,;,(accepted for processing after 4:30 P.M. Forassistance in completing this application, please call (772) 462 4'553'; during regular office hours (8:00 AM - 5:00 PM), Monday through Friday. ro �lfgEmergency 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. owtvxMr yr r.uvstj.�"''_ DEPARTMENT OF ) ITH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT CONSTRUCTION PERMIT FOR: OSTDS Abandonment APPLICANT: (Tetley Grove Inc) PROPERTY ADDRESS: 4520 S Header Canal Rd Fort Pierce, FL 34945 LOT: 35-36- 38.51/2 BLOCK: .5 112 SUBDIVISION: PROPERTY ID #: 22363.3100010005 APPLICATION #: AP 1118658 J DATE PAID: FEE PAID: RECEIPT #: DOCUMENT #: PR915492 [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER] [OR TAX ID .NUMBER] SYSTEM MUST BE CONSTRUCTED IN . ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SECTION 381.0065, F.S., AND CHAPTER 64E-6, F.A.C. DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN MATERIAL FACTS, WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL AND VOID. ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL, STATE, OR LOCAL PERMITTING REQUIRED FOR DEVELOPMENT OF THIS PROPERTY. SYSTEM DESIGN AND T [ 900 ] GALLONS / GPD Septic CAPACITY A [ ] GALLONS / GPD CAPACITY N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS] K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @[ ]DOSES PER 24 HRS #Pumps [ ] D [ ] SQUARE FEET R [ ] SQUARE FEET A TYPE SYSTEM: [ ] STANDARD I CONFIGURATION: [ ] TRENCH N F LOCATION OF BENCHMARK: I ELEVATION OF PROPOSED SYSTEM SITE E BOTTOM OF DRAINFIELD TO BE L D FILL REQUIRED: [ 0.00 ] INCHES O T H E R SYSTEM SYSTEM [ ] FILLED [] MOUND [ ] BED [ ] [ABOVE/ BELOW I BENCHMARK/REFERENCE POINT ][ABOVE/ BELOW] BENCHMARK/REFERENCE POINT EXCAVATION REQUIRED: [ ] INCHES Have the tank abandoned in accordance with the following procedures:(a) The tank shall be pumped out.(b) The bottom of the tank shall be opened or ruptured, or the entire tank collapsed so as to prevent the tank from retaining water, and(c) The tank shall be filled with clean sand or other suitable material, and completely covered with soil. Have the system inspected by the health department after it has been pumped and ruptured but before it is filled with sand and SPECIFICATIONS BY: Michael Spears TITLE: Registered Septic Tank Contractor APPROVED BY: TITLE: Environmental Specialist II Andrew R Gatewoo DATE I S SUED : 08/28/2013 EXPIRATION DATE: St. Lucie CHn 11 /26/2013 DH 4016, 08/09 (Obsoletes all previous editions which may not be used) TnrnrnnratoA! AAA-c nnR_ FAr Page 1 of 3 NOTICE OF RIGHTS A party whose substantial interest is affected by this order may petition for an administrative hearing pursuant to sections 120.569 and 120.57, Florida Statutes. Such proceedings are governed by Rule 28-106, Florida Administrative Code. A petition for administrative hearing must be in writing and must be received by the Agency Clerk for the Department, within twenty-one (21) days from the receipt of this order. The address of the Agency Clerk is 4052 Bald Cypress Way, BIN # A02, Tallahassee, Florida 32399-1703. The Agency Clerk's facsimile number is 850-410-1448. Mediation is not available as an alternative remedy. Your failure to submit a petition for hearing within 21 days from receipt of this order will constitute a waiver of your right to an administrative hearing, and this order shall become a 'final order. Should this order become a final order, a party who is adversely affected by it is entitled to judicial review pursuant to Section 120.68, Florida Statutes. Review proceedings are governed by the Florida Rules of Appellate Procedure. Such proceedings may be commenced by filing one copy of a Notice of Appeal with the Agency Clerk of the Department of Health and a second copy, accompanied by the filing fees required by law, with the Court of Appeal in the appropriate District Court. The notice must be filed within 30 days of rendition of the final order. Planning & Development. Services Building & Code Regulation Division 2300 Virginia Avenue Fort Pierce, FL 34982 Phone:(772)462-2172 Fax:(772)462-6443 September 04, 2013 ASBESTOS NOTICE Asbestos Notice to Contractor L E B DEMOLITION & CONSULTING CONTRACTORS INC RANDLE L BECKFORD 2290 N US 1 FORT PIERCE, FL 34946 RE: Building Permit Number 1309-0030 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 Date 9/4/2013 9:58:35 AM