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HomeMy WebLinkAboutBuilding permit app,change of contractor 10.29.20 All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �^r1� Date: � as o2 oao Permit Number: �I - 03� I L� ° .p -: Building Permit Application Planning and Development Services Building and Code Regulation Division Commercial Residential 2300 Virginia Avenue,Fort Pierce FL 34982 Phone:(772)462-1553 Fax:(772)462-1578 PERMIT APPLICATION FOR: Ie Peiq Qom. &-3-hlqq St-a(� PROPOSED IMPROVEMENT LOCATION: 1_ if_trC Address: L l.�l.t�l � � t � y� i Property Tax ID#: 1-3 500, - o a 0 Dr Lot No.�_ � I Site Plan Name: e,�nn -- c ff Block No. Project Name: Lk) I�Q�) C.C,Q I DETAILED DESCRIPTION OF WORK'- ` I , I New Electrical Meter Second Electrical Meter CONSTRUCTION INFORMATION: 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: /000+ Sq. Ft. of First Floor: Cost of Construction: $ 01,50Q Utilities: _Sewer XSeptic Building Height:02,5_4"PT. OWN ER/LESSEE: CONTRACTOR: Name lT✓O Name: w C� C� ,l�s Address: j 61A-01 ZJIoD Company: !� City Isle-S State: R, Address: (.� N Zip Code: 31 0 Fax: City: c .State•�1-- I LL( �' Phone No. L5/'5a(o-5 9.3Go Zip Code: 3�117?J Fax: E-Mail: Cues Coro Phone No r7"72- 9Yd, '025 9r Fill in fee simple Title Holder.on next page(if different E-Mail /J&- Y1S+. -Cd I from the Owner listed above) State or County License C z3Yi 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. I I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: t Applicable MO GE COMPANY: _Not Applicable Name: me: Address: Address: City: State City: State: Zip: Pfione Zip: Phone: FEE;e: PL TLE HOLDER: _ Applicable B ING COMPANY: of Applicable Nam "Name: Add : Address: City: City: Zip: Pho Zip: Phone: I OWNER/CONTRACTOR AFFIDVIT: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 strut tune 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 paying twice for improvements to your property. A Notice of Commencement must be recorded in the public recolds 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 o r Notice of Commencement. Sign a ess Contractor as nt for Owner Signa of Con r nse o STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF S^� rn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of !� Physical Presence pir Online Notarization x Physical Presence or Online Notarization this 2g'day of r 2020 by this 2�day of 2020 by CL S Name of persoh making ement. Name of pe son makindslatement. Personally Known Y OR Produced Identification Personally Known x OR Produced Identification I Type of Identification Type of Identification Produced 1 y� Produced (Signature of Notary Public-State Syr rw Notary Public State of io( na re of Notary Public-Stat a�w Notary Public State of Floe a �j y4 � au' Merritt W�da p �ie Merntt Woodard Commission No. O Z My Commission HFi 0 9COmml ion NO. 3 O� S ommission HH 0398 Expires 09107/2024 •� ' E,p , 09107/2024 ho �Ot M1� REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. a i a a PLANNING &DEVELOPMENT SERVICES - BUILDING&ZONING DIVISION • a 2300 VIRGINIA AVE FORT PIERCE,FL 34982 z (772)462-1553 FAX 462-1578 i CHANGE OF CONTRACTOR,SUBCONTRACTOR OR CANCELLATION OF PERIVIT y f 111.1F asr sFr l C•l•oNr or rur For i owlNc- 3 -VCHANGE-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 Notiee.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 t 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. I 'CANCELLATION OF PERM t--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: 2--1 Permit Number: Site Address: ::a-o� __ Q� P� l t tM i NA— &( :1 bd�i lP—State License SLC License 2 Original GC,GC,subcontractor or owneiftild lhhl-�S StateLicease�iZ, 14 SLGLicense New GC,su contractor h Reason for Cancellation woe_% "In I The undersigned does hereby agree to indemnify and hold harmless Stlucie County;its-officers;agents and employees from all costs,fees or damages arising from any and all claims of action for any r on,-which may arise as a result of this change of contractor/subcon r ollation of permit-A permit nnot be-ea celled-if Bork has been performed. SIGNATURE OF OWNER(or ownedbpuilder) S=NANffifff� CO �\ applicable) PRItiT_ NAME (�riG4S 14 — r State of Florida,County ounty State of Faorithi,County of SL Lucie County The following imm t wus aeknowl�before me this Thee.��o'tlowing iastrtn rn A-as acknowledscd before me this a dap o 34_day of 20�by G C ✓• v1/»/..ispcisonalty Imowu to ruc I - �tifio rs persona ly known to 4 r to has me or who G pr os ID. iu as - 1©/aFlu Signatureofl o Date SiguatareorNolary Date ,t k Rev ��`' Notary PubhgState of Florida 1 �+t1YP�`': EVAWUNAR Bunnie Merritt Woodard ��- Notary Public-.State of Florida N My Commission HH 039826 lP Commission N HH 92677 Expires 09/07/2024 ?Fri° rhy Comm.Expires Sep 26,2024 or a Banded through National Notary Assn. 7 I I