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HomeMy WebLinkAboutPermit Renewals (2) PLANNING AND DEVELOPMENT SERVICES DEPARTMENT BUILDING AND CODE REGULATIONS DIVISION 2300 VIRGINIA AVE _-- ..:„........:a>_,._.. .W _ ..�„,..,._.....� FORT PIERCE,FL 34982 RECEIVL—iM (772)462-1553 Fax(772)462-1578 SEP 26 N PERMIT RENEWAL REQUES ISr, Lucie County, Permitxit,c PERMIT NUMBER d ad� ADDRESS: v ts 1AJ 01 �f�' �4 ,am requesting that the above permit be renewed. I understand that I must schedule and pass alf 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. Justification 4 94 ,4 5 6� ;P/2-6 ec�-7— C ►��� e—jLm 1,0/jAJ Dy c J S D4-�PcT> c7m isle-•. 9 O ffJBLDR OR C 01N T C SIGNATURE DATE 7 W 1>6 tel/ Print Name STATE OF FLORIDA COUNTY OF -6)c- yU ACKNOWLEDGED BEFORE METMSas DAY OF 120 BY `1 a�„e.a L�104d1 +ill r: WHO IS PERSONALLY KNOWN TO ME OR HAS PROVIDED -FL IDL– AS IDENTIFICATION. STATE OF FLORIDA,County of - DEA NA M19SIO IE GIVENS G 022 MY COMMISSION#GG 022023 EXPIRES:December 16,2020 SIGNATURE OF NOTIkkY '%;;u6�gP•- BondedlW%NbtaryPuWfcUndenvHters ------------------ 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=$113.75 (renewal fee) Revised 7/21/2014 All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: \ Permit Number: T� Building Permit Applicata n RECEIVE® Planning and Development Services SEP 2 6 P/019 Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 �Iucle unty, Permitting Phone: (772)462-1553 Fax: (772)462-1578 Commercial Resid PERMITTYPE: PROPOSED IM�R' OUEMENT LOCATION; iL Address: Property Tax ID#-J� `7J lU �p f�-�a`�� —OOO— Lot No. rJ Site Plan Name: L'�"C-�F t— C���� 5_1 L' L�'-71/.0013 I Block No. Project Name: ©ET ILE© L1E}SCRIPTI©N OF WORK &�C J S-rl AJ 6— uJ/ 1 JD ole} S A-AJ 194 AJ T_ 96741e- LX-FE72_/vim. 'Doo f2s "6-x-"r A-j -- —ro ?� 7— �I�s O STRUCTION 1211 RMA ION; Additional work to be performed under this permit-check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Electric _Plumbing _Sprinklers _Generator. _Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction:$ �y�d d o Utilities: —Sewer —Septic Building Height: OWNS /LE�S�SEE. CONTRALTO Name f}f(�1 �� D �D Name: � Address: �tJ� D! l�s�%-%A' Company: M.f�/J� ..�y e6ldS1, �/U G. B,' Cityf� '' // State: L- Address: �� �5!�"-:`• 5(��"n'l5 ble Zip o e: -3-3 `/0-7 Fax: City: DSL%'. %� / State�C, Photo. 1—' z-j _( Zip Code: �5yff 93 Fax: E-MaiAA- _r 7 77 6_1-'91+,(L- fig Phone No -7 7-2- =7i0 3 (!o 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. SUPP M N AL CONSTRU i�N LIEN LAW WORm7 DESIGNER/ENGINEER:' _Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE 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 permit holder to build the subject structure which is in conflict with any applicable Home Owners Association rules;bylaws or and covenants 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 T E FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LE 0ER OR AN ATTOR BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF -The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this � day of 20A by this day of 20_ by YVN % IQ Was O t V 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 Produced (Signature of Notary blit- wjj�gRIEGNENS (Signature of Notary Public-State of Florida) "� ''• D MISSION#GG 022023 �:"•'''�'•: COM �s Commission No. �Cr0 a _ . �; S.Decemb x%2020 t, publlcunderv+rltE commission No. (Seal) ��edTyNot" •': .. sa 6 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. Planning&Development Services Department Building&Code Regulations 2300 Virginia Avenue RECEIVED Fort Pierce,Florida 34982 (772)462-1553 S E P 2 5 2019 OWNER/BUILDER AFFIDAVIT DISCLOSURE STATEMENT F.S.489.103(7)EXEMPTIONS ST, l.ucle 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 64!4L cost,which could include loss'of wages during recovery from their injury. Initial I ' To qualify for this exemption under this subsection,an owner must personally appear and sign the building permit application and initial the above. fhereby 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 Zoning Department tq the lorida State Department of Professional Regulation. Si ed and ac owled n is day of S Ili+ of 201 'Owner/Builder Signature STATE OF FLORIDA COUNTY OF 5 k .%-% %e The foregoing instrument wascknowledged before me this day of 'fit �� ,20_1!_, by `lh q,*1A,%r_%0 b V v: who is personally known-tome,or who has produced L ` JJ asidentification. DEMNA MAPJE GNENS Signature of Not Type or Print Name of NotMWY O KION#GG 022023 Title:Not Public Commission Number GCrd�.d '�' p(PIRES:Decemberl(i.2020 ary :,; Pubne gondedThtuNotenl •. '•poi«��'•• _ ..=�sFy:ey;a+su'sa SLCPDSD Revised 05/15/2014