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Date: Fee Lue: Receipt# �� Permit #
St. Lucie County Building & Zoning SCgNNEU
2300 Virginia Avenue Ft. Pierce, FL 34982-5652 Q
Tel. •462-1553 St �UCie C
SPECIALTY PERMIT APPLICATION °�ntY
Electrical ❑ Plumbing ❑ HVAC ❑ Fence
❑ Shed ❑ Demolition ❑ Gas ❑ Siding
Seepage 2 for instructions and additional paperwork required for specialty permits
1. Location/Site Address: �j f—� ��if� /qve—
2. Parcel ID Number: , �� 60 l .-- '5�1 D R <-- m C.) p _
Office Use
Only
Section
Townshi
Ran a
Ma Pa a
Zonin
Land Use
Initials
.
S%
.
3. Description of Project, or Work Activity: to
(2 c � �e S� ��...-P � Tt s � s�,o � ���s ,., h��-.� •f ��w�r
�itS•�.�-¢P rvF.z j�e��� � � ��`�c�Q., a„�f I��r-,�,,
4. Owners Information ter— 5. Contractors Information F—G,OOD,�ot-��
Name: s C U L it i Lfi-*�� I �4cg % FL Reg/Cert #:
Address: ,
.Si%,Jeyt Iv► 4 `N County Cert#:
City: 61'f State: % Business Name:
Zip: 3 y �6'Y Phone: h Y QJ Phone Z - 2,14- Fax
6. Value of Construction: S
OWNER'S AFFIDAVIT: I certify that all of the information contained in this application is correct and that all work wi11 be done
in compliance with all applicable laws regulating construction and zoning.
PRINT QUALIFIERS/OWNERS NAME SIGNA OF QUAL[FIER/OWNER
STATE OF FLORIDA, COUNTY OF J 61 &1U (� ACKNOWLEDGED BEFORE ME THIS V DAY OF
20& BY - �� WHO IS 1'bKSONALLY KE OR WHO HAS PRODUCED
AS IDENTIFICATION. f
12 a 0 Y(n� d 14 Apse f: lSui 7'
SIGNATURE OF NOTARY TYPE OR PRINT NAME OF NOTARY -NOTARY PUBLIC-S" OF FLORID/
TITLE: NOTARY PUBLIC COMMISSION NUMBER DD St/S/ %7_SZ f, Anne P Suit
Commission #DI}41477,
Expires: APR. 04, 2001,
Bonded Thru Atlaadc Bonding Co., Inc
St. Lucie County Specialty Permit Application rev. 8/25/05 drag
NOTICE TO OWNER: FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY REbULf 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 $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 the
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) 462-1553, 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.
St. Lucie County Specialty Permit Application rev. 8/25/05 dmg
Property Appraiser - St.Lucie County,
FL
Page 1 of 1
PROPERTY RECORD CARD
SLCOCHI Land Trust Record: 1 of 1
<<Prev Next»
Spec.Assmnt Taxes
Exemptions Permits Home Print
property Identification
Site Address: 4696 PALOMAR AV
ParcellD:
1416-601-0085-000-4
Sec/Town/Range: 17:34S :40E
Account #:
7708
da��CIE
Map ID: 14/17S
Land Use:
SF Res
Zoning: RS-3
City/Cnty:
St Lucie County
.,
Ownership and Mailing
Owner: SLCOCHI Land Trust
Address: 1846 E Sanderling Ln
Fort Pierce FL 34982
Legal Description
PLAT OF INDRIO-UNIT 1- BLK 19 WLY 1/2 OF LOT 10 (OR 3246-
1617)
Sales Information
Assessment 2010 Final
Total Land and Building
Date
Price
Code
Deed
Book/Page
2010 Final:
29800
Land Value: 4700 Acres: 0.2
11/12/2010
18000
0001
WD
3246 / 1617
Assessed:
29800
Building Value: 25100
12/19/2005
100
01
QC
2443 / 1074
Ag.Credit:
0
Finished Area: 1249 SgFt
11/8/2005
100
01
QC
2411 / 0945
Exempt:
2/28/2002
59000
00
WD
1500 / 1584
Taxable:
11 /29/2001
38000
00
WD
1465 / 2006
Taxes:
619.38
12/1/1977
18300
00
CV
0279 / 0554
BUILDING INFORMATION
Exterior Features
View:
RoofCover:
RC - Roll Comp
RoofStruct:
GA - Gable
ExtType:
HD -HD
YearBlt:
1960
Frame:
Grade:
D - D
EffYrBlt:
1976
PrimeWall:
BP - Conc Block
StoryHght:
0010 - 1 Story
No.Units:
1
SecWall:
Interior Features
BedRooms:
2
Electric:
AV - AVERAGE
PrmintWall:
DW - Drywall
FullBath:
1
HeatType:
AvgHUFI:
STD
1/2Bath:
0
HeatFuel:
-
Prm.Flors:
VT - Vinyl Tiles
%A/C:
0
%Heated:
0
%Sprinkled:
0
Special Features and Yard Items
Land Information
Type
Y/S Qty.
Units Qual. Cond. YrBlt.
No. Land Use
Type
Measure Depth
SDSF - SITE DEV S-F
Y 1
1 AV AV 2001
1 0100-SF Res
210 -Front Ft
80.28 107.04
THIS INFORMATION IS BELIEVED TO BE CORRECT AT THIS TIME BUT IT IS SUBJECT TO CHANGE AND IS NOT WARRANTED
http://www.paslc.org/prc.asp?prclid=141660100850004 12/7/2010