HomeMy WebLinkAboutGRAVEL PERMIT APPLICATIONf
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
1T
s
Building permit Application
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 X
PERMITTYPE:LIFT & DOCK
PROPOSED IMPROVEMENT LOCATION:
Address: 442 S NARANJA AVE, PORT ST LUCIE, FL 34983
Property Tax ID #: 3419-530-0011-000-3
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
INSTALL BOAT LIFT AND DOCK
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
Lot No.
Block No.
Mechanical , ,_, Gas Tank —Gas Piping — Shutters Windows/Doors
-,_ Electric — _ Plumbing — Sprinklers _,_, Generator ,_ _ Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 15769.00
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR -
Name PAUL GRAVEL
Name: JOY S YANCY
Address:8045 MEADOWLARK LN
Company:SUMMERLIN'S MARINE CONSTRUCTION
City: PORT ST LUCIE State: -
Address:200 NACO RD #C
Zip Code: 34952 Fax:
City: FT PIERCE State: FL
Phone No.
Zip Code: 34946 Fax: 772-464-7470
Phone No 772-464-6090
E-Mail: WOODBENDERZ@COMCAST.NET
Fill in fee simple Title Holder on next page ( if different
E-Mail SUMMERLINSMARINECONSTRUCTiON@GMAIL.COM
from the Owner listed above)
State or County License24217
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW IN ORMATIOW
Name: HI TIDE BOAT LIFTS (LIFT)
Address: 4oso sELVITZ RD
City: FT PIERCE I, State: FL
Zip: 34981 Phone772.464.466Q
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
Name: BENCHMARK ENGINEERING (DUCK)
Address: W60ELAWAREAVE
City: FT PIERCE State: FL
Zip: MW Phone:772-267.1399
BONDING COMPANY: _ _ Not Applicable
Address:
City:____
Zip;
Phone:
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 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 THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FWANCING, CONSULT
"UH YOUR LENDER OR AN ATTORNEY BEFORX RECORDING YOUR NOTICE OF COMMENCEMENT."
Owner
STATE OF FLORIDA COUNTYOFThe forgoing instrument was acknowledged before me
this 9 day of z 207,6 by
Name of person making statement.
1
W✓ v
tur of C tr ctor/L#cen older
S E OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before
this Iq day of rR.04 20cj0 by
JOY S YANCY
Name of person making statement.
Personally Known . i OR Produced Identification Personally Known x OR Produced Identifi
Type of Identification Type of Identification
Produced Produced
(Signature of Notary Public- Stat of Florida) (Signature
Commission No. 609
I. DUPLESSIS
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Public- State of Florida j
No GG330269 (Seal)
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REVIEWS FRONT ZONING #S�7f� m E>�Is iV ETATION SEA TURTLE MANGROVE
COUNTER REVIEW uihEi>INfr �, ViEW REVIEIIV REVIEW
DATE
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BOARD OF PLANNING & DEVELOPMENT
COUNTY A I SERVICES DEPARTMENT
COMMISSIONERSUNTY
. R I . A Building & Code Regulation
CHECKLIST FOR RESIDENTIAL/COMMERCIAL BUILDING PERMIT
Proiect Location: Date:
Permit Number: Technician:
Application completely filled out with Notarized Signatures ............................ YesX No N/A
Sub Agreements with Notarized Signatures (prior to issuance) ..........................
Yes'
No
N/A X
Owner / Builder Affidavit (signed in office)................ ................................. Yes
No_
N/AX
Filled Land Affidavit (prior to issuance) ...................................................
Yes
No
N/AX
Recorded Warranty Deed, if applicable ......................................................Yes
No
— N/Ax
Recorded Notice of Commencement (prior to issuance or inspection).................
Yes^
No
N/A
Utility Agreement or Payment Receipt (prior to issuance).................................Yes
No
N/AX
Vegetation Removal Application with copy of survey....................................Yes No — N/A
Plans. Calculations & Attachments ( 3 copies commercial, 2 copies residential)
Complete set of plans with Engineer / Architect Raised Seal ........................... YesX No N/A
Truss Plans reviewed and approved by Engineer / Architect ............................ Yes No N/AX
Landscaping and Parking plan (under 6,000 sgft)......................................... Yes No _ N/AX
Approved Site Plans........................................................................... Yes No N/AX
Sealed Survey with Dimensions, Finished floor ........................................... Yes No N/AX
Elevations and Setbacks..............................................................
Yes
No
N/AX
Plot plan with Setbacks...............................................................
Yes
No
N/AX
Health Department approval stamped on survey and floor plan ........................
Yes
No
N/AX
Health Department Food Establishment Permit stamped on floor plan ................
Yes
No
N/AX
Manual "J" or Manual "N" Calculations....................................................
Yes
No
N/AX
Signed Energy Calculations (1 set original signatures & signed in 2 spots) ........... .Yes_No
N/AX
Sealed Wind Load Compliance Certification ...............................................
Yes
—No
—N/A
Product Review Affidavit.....................................................................
Yes
No
N/AX
Excavating a pond for fill:
Site plan showing 25-foot(minimum) set back from all property boundaries, size, Yes_ No_ N/AX
shape, location and quantities of proposed excavation and fill areas
Side slopes not to exceed 4 to 1 to a minimum of 3 feet below water level......... Yes No MAX
Depth of excavation does not exceed 12 feet in depth .................................... Yes No N/AX
If Hauling fill off site (excess of 100 cubic yards) you must have a mining permit Yes_ No_ N/AX
Health Department Permit Paperwork....................................................... Yes No N/AX
CD for Fire Department if commercial or multi -family ................................... Yes No N/AX
DEP, SFWMD or Army Corp of Engineers (dock, seawall, SF on beach)............ YesX No NIA
Pool Barrier Affidavit.......................................................................... Yes No N/AX
Ground Sign Landscape Affidavit (signs) ................................................... Yes No _ N/AX
Burn Rate for Sign Cabinets.................................................................. Ye _ / s No N A
RV and Mobile Home Tie -Down Only(2 copies)
Permit Worksheet (Tie -Down Diagram) ...................................................
Yes
No
N/AX
Manufacture Set -Up and Installation Manual......... ,....................................
Yes
No
N/Ax
Manufacture Blocking Documents......................................................... Yes
No
N/AX
Signed Penetrometer Test (1 copy).........................................................
Yes
No
N/A^
StairDetails....................................................................................
Y es
No
N A
/
Mobile Home Inspection Report for Relocation (used only) ...........................
Yes —No
N/AX
Copy of Title for Relocation (used only) ................................................... Yes No N/Ax
Private Property not in a mobile home park
Class "A" Approval from Planning or file # ................................................ Yes No N/A
X
COMMENTS
Revised 10/5/18