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Home My WebLink AboutSUBMITTED PAPERSDate: 1 — '.?-o - I i I Fee Due: D "'1. _, 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 ❑ Demolition ❑ Gas ❑ Siding Seepage 2 for instructions and additional paperwork required for specialty permits ALA C/� C�Unt � F� � /� 3a6�14.S.6,,�,F0�f�'��/-Ce-,r�L39r- 1. Location/Site Address: T ® I n�- i! 7-� "�' "!d � i'� /t �Me ��l f I � 1 2. Parcel ID Number: l/ 0 Q o O � Jj,"F,ce fJse Only Section Township Range Map Page Zoning Land Use Initials 3. Complete Description of Project or Work: F42P(Q'eQ r(VL✓ao4 /l N✓r-fh C f-ed Code Uc'o 46LgQ re_ 4. Owners Information 5. Contractors Information f � �- Name: R t tl L/D O" C (10( �( (C Address: 3 0 D (e f� FL Reg/Cert #: County Cert#: d -0 CO�� e C OTI�l r/ CCl City: 1 �%'I (4��j n�(M State: Business Name: eC- C �� 9 I' s�-� (386) Zip: �91-769'4' Fax�3Fs6) '��3-go3 � d O Phone: ne: �L%S Phone: 6. Value of Construction: $ 11 190 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 regulating nstruction and zonnn �-��es- 7 ® rc/ IOW A/17 PRINT OWNER OR CO TRACTOR NAME SIGNATURE F OWNtR CTR CONTRACTOR STATE OF FLORIDA, COUNTY OF f` `�` %,f fACKNOWLEDGED BEFORE ME THIS DAY OF 20 ffl!�� rV `�a5 '/ —e-L) WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED _ NTIFICATION. DAWN MILONE 4 MY dMOSSION d DD 652W sretiAnag-7-NOTARY R PRINT NAME OF NOTMY -*e 6(p1AES: Mgtoh 22, 703 Bonded Thor Notary Puolk Undenvdtt* COMMISSION NUMBERR'� " 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 Wrill 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 l� NOTICE TO OWNER: , FAIbz� TO RECORD A NOTICE OF COMIIENCEMEI�" XY 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 $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 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 0 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 G'ouiityBuilding and Zoning, 2300 Virginia Avenue, Fort Pierce, FL 34982.1 All permit •applications must be filled out completely before submission. No applications will be accepted 1or,processi' "after 4:30 P.M.:For,assistance, in completing this application, please call (772) 462-.1553, during regular office hours ($:00 AM - 5:00 PM), Monday through Friday:'..,;r t 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.