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Home My WebLink AboutSUBMITTED PAPERSDtite: JFee Due:',,_ �1 Receipt# �,'Iermit # Planning & Development Services Building & Code Regulations Division 2300 Virginia Ave. SC,A� p Fort Pierce, FL 34982 8t. e EQ V t"tv7� - - - (772)462-1553 UCie �Otlht, Z`L SPECIALTY PERMIT APPLICATION CdElectrical ❑ Plumbing ❑ HVAC ❑ Fence ❑ Shed ❑ Demolition ❑ Gas ❑ Siding Seepage 2 foor instructions and additional paperworkk requiredfor specialty permits C 1. Location/Site Address: 1(� �/ iJ uJ A A(f 2 �d r4e 1 q� 1� i �� 7 �°S � /7'� ^ R rf i" p f ercA-) FL � y7 2. Parcel ID Number: I / Township Range Map Page Zoning an Use Initials QfTwe Use Section Only 3. Complete Description of Project or Work: vj,'-fc, c ltzd Cowie v r a (4-l 4. Owners Information 5. Contractors Information Name: F�V-e/--Oar2 Cot% l'vv// (l es Address: 3 0y M, 0i e �. City: 9 ��+r �yha✓c7 State: C7 / ne Zip: Ph 6. Value of Construction: $ J �0 0 FL Reg/Cert #: County Cert#: p- 45;�6 j Business Name: Al" it �Iec+ri�cQ B) �o3tF Phone•6 iSq- 76i6 Fax3 S (- ) 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 nstruction and zonnn PRINT OWNER OR CONTRACTOR NAME Q SIG ATURE 61FO ONTRACTOR STATE OF FLORIDA, COUNTY OF \ , _ �iC.P � �� 114 0 PJ THIS ACKNOWLEDGED BEFORE ME DAY OF , 20 BY 17 I WHO IS PERSONALLY KNOWN TO ME OR WHO NTIFICATION. SI OF NOTARY COMMISSION NUMBER TYPE OR ARY ---®AWN MILOle MY COMMISSION 8 DD 852ti87 EXPIRES: Match 22, 2013. Bonded Thru Notary Public Unde�vtila� 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 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: FAILURE 1,:-kECORD A NOTICE OF COM IENCEIVItNT -MAI ;SULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND T`i`vBTAIN 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 AVAC Attach 2 residential energy studies, 2* manual J calculations. 2 sets of duct layouts for new system -or ll"replacement This. application can be'subrnitted to St. Lucie County Building and Zoning, 2300 Virginia Avenue, Fort Pierce, FL 34982. tAl1=.permit applications must be filled out completely before submission. No applications will be accepted-for,pr-ocessing after 4:36 P;1VI For assistancesiri;completing this application, please call,(772) 462-1553, during regular office hours (8:OO.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.