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Home My WebLink AboutRenew with new permit All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO-BE ACCEPTED Date:. Permit Number: a,doS �4�O'�3 RECEIVE 5 I AUX MWER!, Building Permit Application MAY 2 7 " 'J Planning and Development Services ST.Lucie Coun , Perimittlng Building and Code Regulation Division Commercial Resid 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 PERMIT APPLICATION FOR: LU rZ L 9C m s tea: y r �a3t�z �� aa�� N� atiy I .......�2... :a ..� �.:.;.ew��,ku ' ::, �- -�=.�1�:rie�-�"�.,sh��s�,*'sa.f�w`3 �.: K-�,. '� .q;RE:' �"Si•,.�, ,,.� .. Y.44s w r a 3 ' 'veM,.a.a .�-.:aau ,ems,_ - ._.�.::-x. cxe ,- �' Address: D4 dSr -�am 10 r-i r ncr--- 254-ck'S 2- Property Property Tax ID#: "SL\ k It "may - 66c ' 1 Lot No. Site Plan Name: Block No. Project Name: 1�.��"'�"��`'��,e��t�-c,�u-O—�sr�'+C;•��.c�.�+a-s:�Cr�.�.�,T:.�._T-�r��i��.�...��6.+'^,v�"��;�.a�-�r�K��`:,sI.rt�S.»k..fi.S �f2�as�'�iy-;a-xt_.«�±;��G x�Nie�-.tY"F��-"�,r''a�D^s_-x<.7s��h,��+a.'-�.1�.-�'"1��-,�-(aa�s�.,U3?x`.x��C�t�'' -�.€•'f�`inF1'-`a....�:'��'�ws.,sF..�,+ _�-wi; . gg�. •1v"j c-t-- EovS ¢T�M� r2ary� New electrical Meter Second Electrical Meter-- .... eter ,,�•. • -'. �...t- - a° .sz..v *"i ,�..g€'" �..• '•c "'3-r.3` yts --� �a x^i �a€'`'rh��..5- `+�.. w3n�'tS„a., ;Y .�.Y , ENEv'��'r� P. .�c .�'� ,>�,s,f: �n...:�s -,..e.;• �k .'�i4:--�,..'' n. ,t"iv." ".. ��.Ft=-.-r mks�...z:...�..rr�.a� �v. Additional work to be performed under this permit-check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Pond Electric —Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction:$ X00 . d o Utilities: _Sewer _Septic Building Height: �".t ry •�i ..q ,y ^':.�,a u "va; Wl l �` s ,` ..�'�t`^e^.'s �µy 3� '�v,•. .�. a �„' :.,.:.., _'�..� ..._.`_%' c,.a..- '-''��,, 3"``5u" u s �1�: .* _Name: V.-v t_ Address:^g041:;(?�Scro1�-^: Company= : «oi'ai'6 ; tic-c act 'L_Z C City: a rc'r`,;. �-�= c = State. 1 Address:-:?•G 2;•.5.(9.1 J=s�PortT u�`. t. cc.ar ..-- Zip Code: --0,4�8Z= Fax:.. City: �'o T-•ST.- c�'c�C Stater Cr Phone No. -11 1 Z a 4-0 36 A$ • Zip Code: 54q8 1 Fax: E-Mail: OF_&Ar_t+ONLG Co ciSTn%..)c-t csv q rrik,I Phone No S6. '66-S; E21-9- i Fill in fee simple Title Holder'on next page (if different E-Mail (Jo rQ a C Jo I- from the Owner listed above) State or County License CGC o Lc c. 2CL0_gn If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. If value of HAVC is$7,500 or more,a RECORDED Notice of Commencement is required. DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable Name: _ Name: Address-'C Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLEHOLDER: i Not Applicable BONDING COMPANY: _Not Applicable Name:" _.___. .. Name: Address: Address: City: City: Zip: Phone: Zip: Phone: OWNER/CONTRACTOR AFFINIT:Application is hereby made to obtain a permit to do the work and installation as indicated. f 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,d 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-buildingpermit 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:paying twice for improvements to your property. A-Notice,of Commencement must be recorded:in the public records of St.. Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commencing work or recording our 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- S k,1.J Ik Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of 7. Physical Presence or Oniine Notarization X Physical Presence,or Online Notarization this W",day ofyri5y�=20,-Ib by, this Q--\ day of 20 a s 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 Vii. iD Produced I (Signature of Notary P lic-Stat S' nature of Nota - . IMN111 111111 •'f ON- N&_ DEANNA MARIE GIVENS ,;.n:.., MARIE Commission No. O�—� al)MYCOMMISSION#GG 2�8� ssion No. ATG �'�• MY COMMISMO GG M023 E W-r ,�; EXPIRES:Decemt�16,2020 id; :•= EXPIRES:December 16,2020 ` o,. •iFor it�:�'` Bonded ThN Nota Public Un Bnrrriterm - dP o. Bonded Thru Notary Publle Undorktr)rs�. REVIEWS FRONT ZONING SUPERVISOR PLANS' VEGETATION, SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED '` DATE COMPLETED Rev. Y,€ Fr PLANNING & DEVELOPMENT SERVICES " - BUILDING &'ZONING DIVISIONCOUNTY 2300 VIRGINIA AVE yli=Y €d FORT PIERCE,FL 34982 (772) 462-1553 FAX 462-1578 MAY 2 > .9 ST. Lucie County, Permltting ' CHANGE OF CONTRACTOR,SUBCONTRACTOR OR CANCELLATION OF PERMT PLEASE SELECT ONE OF THE FOLLOWING: rt/ CHANGE OF CONTRACTOR—Change of Contractor is to be signed and notarized by the property owner, and the new contractor of record for the current permit. A new permit application must also be completed with new contractor information and signature. A new Notice of Commencement must be filed in the new contractor's name for job values greater than $2,500 ($7,500 if A/C Change-out). A recorded copy must be submitted prior to commencing any work.There is a$50.00 fee for the Change of Contractor. CHANGE OF SUBCONTRACTOR—Subcontractor changes are to be completed by the general contractor. The new subcontractor must fill out a Subcontractor Agreement Form. There is a $50.00 fee for the Change of Sub- Contractor. CANCELLATION OF PERNIIT—The cancellation of a permit is acceptable only if no work has been done. Cancellation of permit is to be signed and notarized by both the owner and qualifier of record. There is no fee for cancellation of the permit. Date: _��S - ZC3 -2k�"?� Permit Number: Site Address: L-is D'x" f'c'U_=2cL-- State License SLC License Original GC,subcontractor or owner/builder 90.17T7' 'Nete License-02"'--k S((094tSLC License New GC,subcontractor Reason for Cancellation O rzk e t"s-_-L 1 '0136e-_M E rf Bu S k u-39t=s sS The undersigned does hereby agree to indemnify and hold harmless St Lucie County,its officers,agents and employees from all costs,fees or damages arising from any and all claims of action for any reason,which may arise as a result of this change of contractor/subcontractor or cancellation of permit.A permit cannot-be cancelled if work has been performed. SIGNATURE OF OWNER or owner/builder) SIGNATURE GENERAL CONTRACTOR(or new GC,as applicable) PRINT NAME PRINT NAME r-,-ul_ C1'ST State of Florida,County of St.Lucie County State of Florida,County of St.Lucie County The following instrument was acknowledged before me this The following instrument was acknowledged before me this 3.1 day of '►may 20b by 0.el h*%" day of T;20�J by{L d,J who is personally known to me G.6{r'.\\O who is personally known to orN• e or who has produced f- as ID. DEANNA 0 'µ 3�� n ..� f MMMAE GNENS. Sig tifY pXi+y EXPIRES:Dftt ter 16,2020 Signatu pMa, MY COM�(S ION#GG o22023 •y,Od%��J, Bonded Thru Notary Public Undanwriters d = EXPIRES: ,�•,,, -1December 16,2o2o°lBondedTlwNotaryPuD1(cUndenxrktorr Revised 04/15/16 PLANNING AND DEVELOPMENT SERVICES DEPARTMENT • BUILDING AND CODE REGULATIONS DIVISION 2300 VIRGINIA AVE FORT PIERCE,FL 34982 "' REE "�? (772)462-1553 Fax(772)462-157 1ti�. 7 PERMIT RENEWAL REQU EST MAY 2 ST. Lucle County, Permitting PERMIT NUMBER: ADDRESS: ` I D 4 0 S c-oud--Q R. Pr " 'c—:,TcC i, t_ ST\gym 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 period during the renewal period. Justifications -�1 al.l t�L 1 tils r��CL3-0•Q 0 N OWNERBLDR OR CONTRACTOR SIGNATURE DATE Print Name STATE OF FLORIDA COUNTY OF ACKNOWLEDGED BEFORE ME THIS�—DAY OFy�na� 20 oLO BY `\0.J` C kS-Y,\Vt� WHO IS PERSONALLY KNOWN TO ME OR HAS PROVIDED �- \� AS IDENTIFICATION. A :: , DEA"MMIE GIVENS STATE OF FLORIDA,County of .�-�� \Q MY COMMISSION#GG 022023 EXPIRES:December 18,2020 �,V ,_a -'.'„R;„;.,••'� Bonded Thru Notary PubHo Underwriters SIGNATURE OF NOTARY 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