SCOPE OF WORK APPLICATION INDIAN RIVER COUNTY ... - …

1 SCOPE OF work APPLICATION . INDIAN RIVER COUNTY /CITY OF VERO BEACH. App. Date: _____. PARCEL NUMBER: __ __ - __ __ - __ __ - __ __ __ __ __ - __ __ __ __ - __ __ __ __ __ . __ FL Bldg Code: _____. (from tax notice \ receipt) Supplements: _____. OWNER'S NAME: _____ JOB ADDRESS: _____. CONTRACTOR NAME _____ LICENSE #_____. CONTACT INFORMATION : PHONE # _____FAX #_____ E-MAIL _____. CONTRACT PRICE: _____* Permit Fee = Contract Price x .00394 + state surcharge = $_____. MINIMUM PERMIT FEE: $ + state surcharge up to $19,039. ** Fence Mechanical Electrical Plumbing Plumbing/Fuel Gas Insulation Irrigation Garage doors Alarm - low voltage or wireless Shed Tie-Down Windows , Doors and Shutters Driveways Solar **Fence permits (check which applies): APPLICANT INDICATES: no pool on property pool on property (see note).

2 NOTE: fence must comply with current pool barrier code unless other approved barrier is provided. Year pool was built _____. SCOPE of the work anticipated in this permit APPLICATION :_____. Attach additional sheets if necessary *NOTICE OF COMMENCEMENT IS REQUIRED IF CONTRACT PRICE EXCEEDS $2,500. (Air Conditioning - $7,500). WARNING TO OWNER: YOUR 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.. _____ _____. Contractor Owner COMP CARD #: _____. As to Contractor: As to Owner: State of _____ State of _____. COUNTY of _____ COUNTY of _____. The foregoing instrument was acknowledged before me The foregoing instrument was acknowledged before me this _____ day of _____, 20___ this _____ day of _____, 20___.

3 By _____ who is ____ personally by _____ who is ____ personally known or who has _____ produced identification. known or who has _____ produced identification. Type identification produced: _____. Type identification produced: _____. _____ _____. Official Signature of Notary Public Official Signature of Notary Public _____ _____. Notary's Name, Typed, Printed or Stamped Notary's Name, Typed, Printed or Stamped Notary Seal: Notary Seal.