HomeMy WebLinkAboutPermit Renewals PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
" ` ` ` BUILDING AND CODE REGULATIONS DIVISION
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2300 VIRGINIA AVE
FORT PIERCE,FL 34982
(772)462-1553 Fax(772)462-1578
PERMIT RENEWAL REQUEST
PERMIT NUMBER: 1806-0347 ADDRESS: 6100 Palm Drive Fort Pierce FL 34982
I Robert Conway ,am requesting that the above permit be renewed. I
understand that I must schedule and pass all required inspections for the permit to be finaled. Further, I
understand that this is a ONE TIME RENEWAL and the permit shall expire should I not receive a
passing inspection during any six month peri d during the renewal period.
Justification C. C
/I s
E LDR OR ONTRACTO SIGNATURE ATE
1O ),- W1c
wuy)d
Print Name
STATE OF FL RIDA
COUNTY OF �( • �—�C�� i
ACKNOWLEDGED BEFORE ME THIS \ 5 DAY OF'�X 20
BY V,S 1 '� �� C O'n q`� WHO IS PERSONALLY KNOWN TO ME OR
HAS PROVIDED `- ISL AS IDENTIFICATION.
STATE OF FLORIDA,County of ��Ci-e �'•,
DEANNA MARIE GIVENS �f
MY COMMISSION#GG 022023 .!
�o EXPIRES:Dcce 2
•.. mbar 16, '20 4
SIGNATURE OF NOT � ,��;°P' Bonded Th,Notary Public Undenvr;fers 1
FOR OFFICE USE ONLY:
Number of Open Inspections:
Total Inspections:
(Divide open by total to get%of open inspections)
Percentage:
Original permit fee: x%open = $ Renewal fee
Example: [15 divided by 23=.65(%)] $175(permit fee)x.65=$113.75(renewal fee)
Revised 7/21/2014
Planning &Development Services3�iiling &bode Regilatian Division• 2300 Virginia Ave
• Fart Pierce,FL 34982LM
772-462-2172 Fax 772-462-6443
CERTIFICATE OF TERMITE TREATMENT
CONSTRUCTION SOIL TREATMENT
PERMIT #:_q 0(o - 03 Y7JOB ADDRESS: cldo &/d DP Pray-Pll&
BUILDER/CONTRACTOR:
PEST CONTROL CONTRACTOR: Tfav;;
PEST CONTROL LICENSE #:_T/3 1,379
We, the undersigned, hereby certify that we have pretreated the above described construction for
subterranean termites in accordance with the standards of the National Pest Control Association.
Square feet if area treated t/Ocic%r.3c . i Chemicals used: G!' �^
Percentage of solution: O-G Total gallons used:
Date of Treatment: i /-1, Time of Treatment:
Footing Slab
1E't Treatment lstTreatment
Re-Treat Re-Treat
Drive y dG%ir` lo�'d Pools
i7lst Treatment 1St Treatment
Re-Treat Re-Treat
Other --Perimeter for Fin I pection
1st Treatment
Re-Treat 1-1
gnatur minator Date
f
r
Note: There must be a completed form for each required treatment*re-treatment and this fotm must be on the job
site to be picked up by the inspector at time of each inspection or the scheduled inspection will fall and a re-Inspectlon
fee charged.
FBC104.2.6 Certificate of Protective Treatment for preventlon of termites A weather resistant jobsite posting board
shall be provided to receive duplicate Treatment Certificates as each.required protective treatment Is completed,
providing a copy for the person the permit is issued to and another copy for the buiiding permit files The Treatment
Certlfcate shall provide the product used, identity of the applicator, time and date of the treatment,site location,area
treated, chemical used,percent concentration and number ofgallons used, to establish a verifiable record of
protective treatment. If the soil chemical barrier method for termite prevention is used, final exterior treatmentshall
be completed prior to Anal building approval,
St Lucie County requires for the final inspection for CO, a Permanent Sticker to be placed on
the electrical panel box cover, listing all the treatments and dates of applications.
Revised 7/24/2014
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FLORIDA GENERAL DURABLE POWER OF ATTORNEY
THE POWERS YOU GRANT BELOW ARE EFFECTIVE
EVEN IF YOU BECOME DISABLED OR INCOMPETENT
NOTICE: THE POWERS GRANTED BY THIS DOCUMENT ARE BROAD AND SWEEPING.
THEY ARE EXPLAINED IN THE UNIFORM STATUTORY FORM POWER OF ATTORNEY
ACT. IF YOU HAVE ANY QUESTIONS ABOUT THESE POWERS, OBTAIN COMPETENT
LEGAL ADVICE. THIS DOCUMENT DOES NOT AUTHORIZE ANYONE TO MAKE MEDICAL
AND OTHER HEALTH-CARE DECISIONS FOR YOU. YOU MAY REVOKE THIS POWER OF
ATTORNEY IF YOU LATER WISH TO DO SO. THIS POWER OF ATTORNEY IS EFFECTIVE
IMMEDIATELY AND WILL CONTINUE TO BE EFFECTIVE EVEN IF YOU BECOME
DISABLED, INCAPACITATED, OR INCOMPETENT.
Sell
[insert your name and address] appoint
A ) v /L ?6
[insert the name and address of the
person appointed] as my Agent (attorney-in-fact) to act for me in any lawful way with respect to
the following initialed subjects:
TO GRANT ALL OF THE FOLLOWING POWERS, INITIAL THE LINE IN FRONT OF (N) AND
IGNORE THE LINES IN FRONT OF THE .OTHER POWERS.
TO GRANT ONE OR MORE, BUT FEINER THAN ALL, OF THE FOLL OIA INN pO+AERS.
INITIAL THE LINE IN FRONT OF EACH POWER YOU ARE GRANTING.
TO WITHHOLD A POWER, DO NOT INITIAL THE LINE IN FRONT OF IT. YOU MAY, BUT
NEED NOT, CROSS OUT EACH POWER WITHHELD.
Note: If you initial Item A or Item B, which fallow, a notarized signature will be required
on behalf of the Principal.
INITIAL
. (A) Real property transactions. To lease, sell, mortgage, purchase, exchange, and
acquire, and to agree, bargain, and contract for the lease, sale, purchase, exchange, and
acquisition of, and to accept, take, receive, and possess any interest in real property
whatsoever, on such terms and conditions, and under such covenants, as my Agent shall deem
proper; and to maintain, repair, tear down, alter, rebuild, improve manage, insure, move, rent,
lease, sell, convey, subject to liens, mortgages, and security deeds, and in any way or manner
deal with all or any part of any interest in real property whatsoever, including specifically, but
without limitation, real property lying and being situated in the State of Florida, under such
terms and conditions, and under such covenants, as my Agent shall deem.proper and may for
all deferred payments accept purchase money notes payable to me and secured by mortgages
or deeds to secure debt, and may from time to time collect and cancel any of said notes,
mortgages, security interests, or deeds to secure debt.
(B) Tangible personal property transactions. To.lease, sell, mortgage, purchase,
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exchange, and acquire, and to agree, bargain, and contract for the lease, sale, purchase,
exchange, and acquisition of, and to accept, take, receive, and possess any personal property
whatsoever, tangible or intangible, or interest thereto, on such terms and conditions, and under
such covenants, as my Agent shall deem proper; and to maintain, repair, improve, manage,
insure, rent, lease, sell, convey, subject to liens or mortgages, or to take any other security
interests in said property which are recognized-under the Uniform Commercial Code as
adopted at that time under the laws of the-State'of Florida or any applicable state, or otherwise
hypothecate (pledge), and in any way or manner deal with all or any part of any real or
personal property whatsoever, tangible or intangible, or any interest therein, that I own at the
time of execution or may thereafter acquire, under such terms and conditions, and under such
covenants, as my Agent shall deem proper.
l�(C) Stock and bond transactions. To purchase, sell, exchange, surrender, assign,
.redeem, vote at any meeting, or otherwise transfer any and all shares of stock, bonds, or other
securities in any business, association, corporation, partnership, or other legal entity, whether
private or public, now or hereafter belonging to me.
(D) Commodity and option transactions. To organize or continue.and conduct any
business which term includes; without limitation'r any farming, manufacturing, service, mining,
retailing or other type of business operation in any form, whether as a proprietorship,joint
venture, partnership, corporation, trust or other legal entity; operate, buy, sell, expand, contract,
terminate or liquidate any business; direct, control, supervise, manage or participate in the
operation of any business and engage, compensate and discharge business managers,
employees, agents, attorneys, accountants and consultants; and, in general, exercise all
powers with respect to business interests and,operations which the principal could if present
and under no disability.
(E) Banking and other financial institution transactions. To make, receive, sign,
endorse, execute, acknowledge, deliver and possess checks, drafts, bills of exchange, letters
of credit, notes, stock certificates, withdrawal receipts and deposit instruments relating to
accounts or deposits in, or certificates of deposit of banks, savings and loans, credit unions, or
other institutions or associations. To pay-all sums of money, at any time or times, that may
hereafter be owing by me upon any account, bill of exchange, check, draft, purchase, contract,
note, or trade acceptance made, executed, endorsed, accepted, and delivered by me or for me
in my name, by my Agent. To borrow from time to time such sums of money as my Agent may
deem proper and execute promissory notes, security deeds or agreements, financing
statements, or other security instruments in such form as the lender may request and renew
said notes and security instruments from time.to time in whole or in part. To have free access
at any time or times to any safe deposit box or vault to which I might have access.
L ,(F) Business operating transactions. To conduct, engage in, and otherwise
transact the affairs of any and all lawful business ventures of whatever nature or kind that I may
now or hereafter be involved in.
l
- ---(G) Insurance and annuity transactions. To exercise or perform any act, power,
duty, right, or obligation, in regard to any contract of life, accident, health, disability, liability, or
other type of insurance or any combination of insurance; and to procure new or additional
contracts of insurance for me and to designate the beneficiary of same; provided, however, that
my Agent cannot designate himself or herself as beneficiary of any such insurance contracts.
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execute, and to file all other papers and instruments which the Agent shall think to be desirable
or necessary for safeguarding of me against excess or illegal taxation or against penalties
imposed for claimed violation of any law or other governmental regulation; and to pay, to
compromise, or to contest or to apply for refunds in connection with any taxes or assessments
for which I am or may be liable.
VC (N) ALL OF THE POWERS LISTED ABOVE. YOU NEED NOT INITIAL ANY OTHER
LINES IF YOU INITIAL LINE (N).
SPECIAL INSTRUCTIONS:
ON THE FOLLOWING LINES YOU MAY GIVE SPECIAL INSTRUCTIONS LIMITING OR
EXTENDING THE POWERS GRANTED TO YOUR AGENT.
THIS POWER OF ATTORNEY IS EFFECTIVE IMMEDIATELY AND WILL CONTINUE UNTIL
IT IS REVOKED.
THIS POWER OF ATTORNEY SHALL BE CONSTRUED AS A GENERAL DURABLE POWER
OF ATTORNEY AND SHALL CONTINUE TO BE EFFECTIVE EVEN IF I BECOME
DISABLED, INCAPACITATED, OR INCOMPETENT.
(YOUR AGENT WILL HAVE AUTHORITY TO EMPLOY OTHER PERSONS AS NECESSARY
TO ENABLE THE AGENT TO PROPERLY EXERCISE THE POWERS GRANTED IN THIS
FORM, BUT YOUR AGENT WILL HAVE TO MAKE ALL DISCRETIONARY DECISIONS. IF
YOU WANT TO GIVE YOUR AGENT THE RIGHT TO DELEGATE DISCRETIONARY
DECISION-MAKING POWERS TO OTHERS, YOU SHOULD KEEP THE NEXT SENTENCE,
OTHERWISE IT SHOULD BE STRICKEN.)
Authority to Delegate. My Agent shall have the right by written instrument to delegate any or
all of the foregoing powers involving discretionary decision-making to any person or persons
whom my Agent may select, but such delegation may be amended or revoked by any agent
(including any successor) named by me who is acting under this power of attorney at the time
ILof reference. Page 4 of 6
(YOUR AGENT WILL BE ENTITLED TO REIMBURSEMENT FOR ALL REASONABLE
EXPENSES INCURRED IN ACTING UNDER THIS POWER OF ATTORNEY. STRIKE OUT
THE NEXT SENTENCE IF YOU DO NOT WANT YOUR AGENT TO ALSO BE ENTITLED TO
REASONABLE COMPENSATION FOR SERVICES AS AGENT.)
Right to Compensation. My Agent shall be entitled to reasonable compensation for services
rendered as agent under this power of attorney.
(IF YOU WISH TO NAME SUCCESSOR AGENTS, INSERT THE NAME(S) AND
ADDRESS(ES) OF SUCH SUCCESSORS) IN THE FOLLOWING PARAGRAPH.)
Successor Agent. If any Agent named by me shall die, become incompetent, resign or refuse
to accept the office of Agent, I name the following (each to act alone and successively, in the
order named) as successor(s) to such Agent,
Choice of Law. THIS POWER OF ATTORNEY WILL BE GOVERNED BY THE LAWS OF THE
STATE OF FLORIDA WITHOUT REGARD FOR CONFLICTS OF LAWS PRINCIPLES. IT
WAS EXECUTED IN THE STATE OF FLORIDA AND IS INTENDED TO BE VALID IN ALL
JURISDICTIONS OF THE UNITED STATES OF AMERICA AND ALL FOREIGN NATIONS.
I am fully informed as to all the contents of this form and understand the full import of this grant
of powers to my Agent.
I agree that any third party who receives a copy of this document may act under it. Revocation
of the power of attorney is not effective as to a third party until the third party learns of the
revocation. I agree to indemnify the third party for any claims that arise against the third party
because of reliance on this power of attorney.
Signed this i day of 201_L
our Signature)
[Your Social Security Number]
Page 6 of 6
STATEMENT OF WITNESS
On the date written above, the principal declared to me in my presence that this instrument is
his general durable power of attorney and that he or she had willingly signed or directed
another to sign for him or her, and that he or she executed it as his or her free and voluntary
act for the purposes therein expressed.
[Signature of Witness #1]
[Printed or typed name of Witness#1]
o [Address of Witness#1, Line. 1]
[Address of Witness#1, Line 2]
[Signature of Witness#2]
[Printed or typed name of Witness#2]
/ 6 f [Address of Witness#2, Line 1]
9 o nl- lEEC Ile— /r [Address of Witness#2, Line 2]
A Note About Selecting Witnesses: The agent (attorney-in-fact) may not also
serve as a witness.. Each witness must be present at the time that principal signs
the Power of Attorney in front of the notary. Each witness must be a mentally
competent adult. Witnesses should ideally reside close by, so that they will be
easily accessible in the event they are one day needed to affirm this document's
validity.
CERTIFICATE OF ACKNOWLEDGMENT OF NOTARY PUBLIC
STATE OF FLORI A
COUNTY OF S L4C"
This o¢¢umen was acknowledged before me on //jo/ [Date] by
< he- nw� [name of principal].
If
El Personally known to me
[t-]Tsroduced Identification type:
[Notary Seal, if any]:
(Signature of Notarial Officer)
IRIS BRENDAQUINONES
CommissIon#GG188308 Notary Public for the State of Florida
+Po'Dom February21,2022
Y o��;�'.W*d1MuTmyF2inbsmanc0800-W7019
My com issi expires:
0a -r '�o a
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