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HomeMy WebLinkAboutPermit Renewals _ PLANNING AND DEVELOPMENT SERVICES DEPARTMENT BUILDING AND CODE REGULATIONS DIVISION 2300 VIRGINIA AVE FORT PIERCE,FL 34982 (772)462-1553 Fax(772)462-1578 RECEIVE® PERMIT RENEWAL REQUEs r SEP 2 5 49 =9T, WOP t✓9uryrtyr Permitting p PERMIT NUMBER: d 3' 3 ADDRESS: �/ LIS OLS �/� 5�'7� I, W ,0 O 0 �-`, ,am requesting that the above permit be renewed. I understand that.I must schedule and pas 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 period during the renewal period. O Justification ' &-D �P���n / �N 17 FU u—,Aj-l> GdUcE l7Pfi5 puin��� OWNERBLDR OR CONTRACTOR SIGNATURE DATE Print Name STATE OF FLORIDA COUNTY OF .A. ACKNOWLEDGED BEFORE ME THIS a`5 DAY OF 20 1� BY WHO IS PERSONALLY KNOWN TO ME OR HAS PROVIDED rC �. L AS IDENTIFICATION. STATE OF FLORIDA,County of S �. V c t ,�.•,;;",Yw,�— DEANNAMARIEGNENS ,*• MY COMMISSION#GG 022023 SIGNATURE OF NOT ^Y EXPIRES-December 16,2020 i •'P r Banded 5trnf ;tary Public Underwriter: t ' --------------- 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 All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED u Date: ��a5 ��� Permit Number: NIWA165a l RECEIVED _s�EPY�A MGNENS r r @@ GG 022 23 Building Permit AP ��e- EXPIRES:December 16,PO 0 N Pub i .Unde 'tars Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT TYPE: ROPtJSEDgqI PROVEMENT LOCATION Address: Property Tax ID#: . �f' —//�ob 0 V J -d©G , 3 Lot No. Site Plan Name: k�d-1�- t L� ug do L-DLJ1' 5��-7 ooJ � Block No. Project Name: DE PLED DEMPTION OF SIM oc�'r we)o t) I ✓ i-&- cc-- w -/W b r� woe, �-Te� LeP, S /D E ©f� I "PL!-::-r �'o I�L7 cr,�3 c�f2S lrU o-a� �-r� A-�IJeJ�r 1�T' Std E, AJ&W W 6 a-b Pd-IJ65 CONSTRUCTIO INFOR ATION: Additional work to be performed under this permit—check all that apply: _Mechanical _Gas Tank —Gas Piping _Shutters _Windows/Doors _Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ rJ4 d a a Utilities: —Sewer _Septic Building Height: OWNER LE�S�SE CONTRACTOR: Name rh � wcuDa!.Cg— Name: Address: S�S' OI NS'' I/f eV 6- Company: . - City-WC-r ALAI J92MC.A- FL State: Address': " Zip Code: O Fax: l City: ;l, State: Phone No. Z'7 t'D �� Zip Code: Fax _. E-Mail -17-7 /q-!L &07'3'1 Phone No Fill in fee simple Title Holder on next page (if different E-Mail from the Owner listed above) State or County License If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required. DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: = Phone Zip: Phone: FEE SIMPLEJITLE HOLDER: -_`Not Applicable BONDING COMPANY: _Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: OWNER/CONTRACTOR AFFIDAVIT:Application is hereby made to obtain a permit to do the work and installation as indicated. I certify that no work or installation,has commenced prior to the issuance of a permit. St. Lucie County makes no representation that is granting a permit will authorize the. ermit holder to build the subject structure which is in conflict with any applicable Home Owners Association rules, bylaws or an9covenants that may restrict or prohibit such structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply. In consideration of the granting of this requested permit, I do hereby agree that I will,in all respects, perform the work in accordance with the approved plans,the Florida Building Codes and St. Lucie County Amendments. The following building permit applications are exempt from undergoing a full concurrency review: room additions, accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE T1W FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OJI AN ATTORNEY tEMRE RECORDING YOUR NOTICE OF COMMENCEMENT." Signature of Owner/Lessee/ t der as gent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF 'S�-,1.uc A-Sk' COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this' 5 day of Staab 20� by this day of 20_ by Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification' Produced L L Produced .(Signature of No 0o,�p23 (Signature of Notary Public-State of Florida) i:��.,��ry' '•; W COMMISSION bet 16,Z0�6 Commission NoCommission No. (Seal) .P ndad�►'mNo I,�•�•Bp,M�g, REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 2/7/19 Planning&Development Services Department Building&Code Regulations • R 1 U A 2300 Virginia Avenue RECEIVED Fort Pierce,Florida 34982 (772)462-1553 SEP 2 5 2019 OWNER/BUILDER AFFIDAVIT DISCLOSURE STATEMENT F.S.489.103(7)EXEMPTIONS ST, Lude County, Permitting State law requires construction to be done by licensed contractors. You have applied for a permit under an exemption to that law. The exemption allows you,as the owner of your property,to act as your own contractor even though you do not have a license. You must provide direct, on-site supervision of the construction yourself. You may build or improve farm outbuildings, a one-family or two-family residence for your use and occupancy. You may also build or improve a commercial building at a cost not exceeding $75,000.00 as long as it is for your own use or occupancy.You may not build or improve said structures for the purposes of selling or leasing that building. If you sell or lease a building you.have built or improved within one year after construction is complete, then a presumption is created that it was built or improved for sale or lease,which is a violation of this exemption. You may not hire an unlicensed person to act as your contractor or to supervise people working on your building; it is your responsibility to make sure that people employed by you have licenses required by state law and by county or municipal licensing ordinances. You may not delegate the responsibility for supervising work to a licensed contractor who is not licensed to perform the work being done. Your construction must comply with all icable laws,ordinances,building codes,and zoning regulations. Initial . I understand that the building official and inspectors are not there to design or give advice on ho meet the minimum code. Initial. I understand that as an owner-builder that any contract disputes with sub-contractors and I must be handled in a civil court with the advice of an attorney. This department will not mitigate any contract disputes. Initial I understand that if I compensate any person or company for work performed they are required to be licensed in this jurisdiction. If for some reason they do not possess a license,I may be responsible and liabe o the cost of the license. Initial I understand that if any person that is unlicensed and uninsured gets injured on my construction project- they may be entitled to workmen's compensation. I could be held liable for all doctor, lawyer and related�}e ica cost,which could include loss of wages during recovery from their injury. Initial L To qualify for this exemption under this subsection,an owner must personally appear and sign the building permit application and initial the above. I hereby acknowledge that I have read and understand the above disclosure statement and that I further understand that any violation of the terms of the owner/builder exemption shall be reported by the Building a Zoning Department tQ the Florida State Department of Professional Regulation. Si ned and ac 79m,,,, �- day of of 20 j . OwnerBuilder Signature STATE OF FLORIDA COUNTY OF 5 k .�• e The foregoing instrument was acknowledged before me this Z.5 day of 2011 by Mg 1^e w xA_'�o-6 A b o y who is personally known to me,or who has produced as identification. • e �n na <, �! g ' .„....... pEANNAMkRIEGNENS Signature of Not Type or Print Name of Notary :'t''4`'=_ My of �1oN#GG 022023 Title:Notary Public Commission Number GCrd d "= EXPIRES:Dece'” 16' 20 • •P=` gonded7tw Notary Public t.ln@et+�,'?Rr` SLCPDSD Revised 05/15/2014