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Home My WebLink AboutSUBMITTED PAPERSDate: I Fee Due: 1'�\j v (Receipt# Xa (- J_O � Permit # Oz— Planning & Development Services Building & Code Regulations Division SCA 2300 Virginia Ave. leo Fort Pierce, FL 34982 St. sY (772)462-1553 CuCie C,-Ou y SPECIALTY PERMIT APPLICATION ❑ Electrical ❑ Plumbing ❑ HVAC ❑ Fence ❑ Shed ❑ Demolition ❑ Gas ❑ Siding Seepage 2 for instructions and additional paperwork required for specialty 1. Location/Site Address: 2. Parcel ID Number: ---3 "1 \ Ck (")COCa. Office Use Section Only 1 3. Township I Range I Map Page I Zoning I Land Use I Initials - P\ 4. Owners Information 5. Contractors Information Name: FL eg/Cert #: e W rV Aa Pc^�U� v.�CA NQU\ �. Address: k1��-�;,��__�='_`.�� T.�;: _ County Cert#: City: q, cszs L State: ol,;� IL Business NamZFax-_ Zip: ` �� Phone TIT 6. Value of Construction: $ OWNER'S AFFIDAVIT: I certify that all of the information contained s applica 'on s correct and that all work will be done in compliance with all applicable laws regula ' c structio zoning. P T OWNER OR CONTRACTOR NAME S NA F O OR CONTRAlux STATE OF FLORIDA, COUNTY OF p ACKNOWLEDGED BEFORE ME THIS DAY OF 20 BY S S C • WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED . •? g • AS IDE TIFICATION. �V 0 • / (0 D• v V V " v d/r1. P� P (seal) SIG URE OF NOT Y TYPE OR PRINT N O OTARY J COMMISSION NUMBER NOTICE TO OWNER: FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT 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: FAILURE RECORD A'NOTICE OF COMNIENCEMEIVT 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 CONIMENCEMENT. 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 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 Work Activity 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 I ' /, 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`subn itied 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 4 ❑ 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 M— completing this application, please call,(772) 462=1553; during regular office hours (8:00 AM*- 5:00 P1V1), 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. Oct 21, 2011 03:38 PM PLANNING AND DEVELOPMENT SERVICES DEPARTMENT Building and Code Regulations Division 2300 VIRGINIA AVE. FORT PIERCE, FL 34982 (772)462-1553 PERMIT RENEWAL REQUEST ADDRESS: �1 Jilam_IT NUMBER: O , AM REQUESTING THAT THE ABOVE PERMIT IS RENEWED FOR 18 MONTHS. I UNDERSTAND THAT I MUST SCHEDULE AND PASS ALL REQUIRED INSPUONS FOR THE PERMITTO BE FINALED. FURTHER; I UNDERSTAND THAT THIS IS TRENEWAL AND THE PERMIT SHALL EXPIRE SHOULD I NOT RECEIVE A PASS PEC N DURING ANY SIX MONTHS PERIOD DURING THE RENEWAL: PERIOD. OR CONTRACTOR SIGNATURE DATE STATE OF FLORIDA, County of ACKNOWLEDGED BEFORE ME THIS 0` DAY OF BY r) A-e- WHO IS PERSONALLY TO ME , OR HAS PROVIDED AS IDENTIFICATION. OF FLORIDA, SIGNATURE OF ISIOTARY (] COMMISSION NUMBER AUDREy B. HUMPHREY My COMMISSION # EE 061159 EXPIRES: March 6, 2015 Bonded ThruNotaryPublicUnderwriters FOR OFFICE USE ONLY: RENEWAL FEE: $ No. of Open Inspections _ Total No. of Inspections = t SEAL (% of Open Inspections). Original Permit Fee $ x Open Inspections (%) = $ (Renewal Fee). Example: [15 = 23 = .65(%)] $175.00(permit fee) x .65(%) = $113.75 (Renewal Fee) SLCPDSD REV 4/11/2011 I Opl( LE C