HomeMy WebLinkAboutSUBMITTED PAPERSDate: I Fee Du`w, d Receipt# ftZ T Permit # I cq . t7
Planning & Development Services SCANNED
Building & Code Regulations Division BY
2300 Virginia Ave. 9t: 1=WGie C-00149
_ Fort Pierce, FL 34982
- (772)462-1553
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SPECIALTY PERMIT APPLICATION
electrical
❑ Shed
❑ Plumbing ❑ HVAC ❑ Fence
❑ Demolition ❑ Gas ❑ Siding
Seepage 2 forr instructions and additional paperwork required for specialty permits
1. Location/SiteAddress: SjI � l jfQ,�CL ��( l�/✓+
2. Parcel ID Number: , L J —low- 0 o A-- 0oo 13
e?ffice Use
Only
Section
Township
Range
Map Page
Zoning
an Use
Initials
3. Complete pescription of Project or Work:, ,[C
f,
4. Owners Information 5. Contractors Information
Name: .�l i%%Gf/� II&A
Address:
City: State: 1.
Zip. 3 q '1 J - Phone: n .00 -
6. Value of Construction: $
FL Reg/Cert #:
000
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h l%,
County Cert#: i l0
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Business Name:
Phone: q �U QVW Fax• (I
OWNERS AFFIDAVIT: I certify that all of the information contained in this application is correct and that all work will be done in
compliance with all applicable laws regulatin onstructi 0, and zoning.
PRINT OWNER OR CONTRACTOR N . SI URE OWNER OR CONTRACTOR
STATE OF FLORIDA, COUNTY OF
ACKNOWLEDGED BEFO E.THIS �l DAY OF , 20, L . BY q r Lt.r
WHO IS PERSONAL OWN ME OR WHO HAS PRODUCED t °:
AS ,DENTIFICATION.
m
X � L
' �Seai�
SI ATURE OF NOT Y TYPE OR PRINT N OF NOTARY o rn co
f
- (n w
COMMISSION NUMBER
zx
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 T(-_ -'CORD A NOTICE OF COMMENCEMENT MAY"�, iJLT 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 COMMENCEM[E'NT.
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 ,
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.