HomeMy WebLinkAboutApplicationBOARD OF (�"PLANNING & DEVELOPMENT
T
COUNTY ® SERVICES DEPARTMENT
COMMISSIONERS ,+': �1`os a:t`
�t Building iiR Code Regulation
CHECKLIST FOR RESIIDENTIAL/COMMERCIA L BUILDING PERMIT
Project Location: �.� _�� � � � / Date:
Permit Number: Technician:
to uired Documents:
Application completely filled. out with Notarized Signatures ............................ Yes No _— N/A_
Sub Agreements with Notarized Signatures (prior to issuance) .......................... Vc- No \/lip/A
Owner / Builder Affidavit (signed in office) ................................................. Yes No N/A
Filled Land Affidavit (prior to issuance)................:.....................................Yes /No N/A.
Recorded Warrany Deed, if applicable ........................ I....... I ....................1. Yes_._.. No — N/A_.v'
Recorded Notice of Commencemeznent (prior to issuance or inspection) ............... Yes_ � No — N/A ----
Utility Agreement or Payment Receipt (prior to issuance) .... . ....................
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 ........................... Yes V No NIA
Truss Plans reviewed and approved by Engineer I Architect......... I .................. Yes / No N/A
a
Landscaping and Parking plan (under 6,000 sgft)......................................... Yes No N/A.
ApprovedSite Plans........................................................................... Yes No _ N/A —
Sealed Survey with Dimensions, Finished floor ........................................... Yes - No N/A
Elevations and Setbacks.............................................................. Yes '/ No _ N/A
Plot plan with Setbacks............................................................... Yes,V No — N/A�
Health Department approval stamped on survey and floor plan ........................ Yes No N/A f
Health Department Food Establishment Permit stamped on floor plan ................. Yes_____ No N/A V/
Manual "J" or Manual "N" Calculations................................................... WSJ No N/ASigned Energy Calculations (1 original signature) ....................................... Yes J No N/A
Sealed Wind Load Compliance Certification ................ I..................,.....,..... Yes of No___N/A'
ProductReview Affidavit..................................................................... Yes tl No N/A
Other:
Health Department Permit Paperwork....................................................... Yes
No
N/A �
CD for Fire Department if commercial or multi -fancily ...................................
Yes
No
N/A
DEP, SFWMD or Army Corp of Engineers (dock, seawall, SF on beach)............
Yes
No
N/A
PoolBarrier Affidavit..........................................................................
Yes
No
N/A +/
Ground Sign Landscape Affidavit (signs) ...................................................
Yes
No
N/1_ v1
BurnRate for Sign Cabinets..................................................................
Yes
No
N/A ,J
R V and Mobile Howe Tie -Down € nIX (2 copies)
Permit Worksheet (Tie -Down Diagram) ................................................... Yes
No
N/A
Manufacture Set -Up and Installation Manual ..............................................
Yes
No
N/A J
Manufacture Blocking Documents ..........................................................
Yes
No
N/A_
Signed Penetrometer Test (1 copy).........................................................
Yes
No
N/A
StairDetails....................................................................................
Yes
No
N/A
Mobile I -Tome Inspection Report for Relocation (used only) ...........................
Yes
No �
N/A_
Copy of Title for Relocation (used only) ...................................................
Yes_
No
N/A
Private Property not in a mobile home park
J
Class "A" .Approval from Planning or file # ................................................
Yes
No
N/A___
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
Planning and Development Services
Building and Cade Regulation Division
2300 Virginia Avenue, Fart Pierce F1.34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
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DESIGNER/ENGINEER:
Not Applicable
MORTGAGE COMPANY:
Not Applicable
Name'
Name:
Address:
Address:
City:
Zip: Phone:
State'
City: State'
Zip: Phone
FEE SIMPLE TITLE HOLDER:
_ _ Not Applicable
BONDING COMPANY:
, Not Applicable
Name
Name'
Address:
Address -
City:
City:
Zip: Phone:
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 Luc a Countyy make no represent tion that is granting a ermit Will aut orize the ermit holder to build the subject structure
which �s in confilet Witt any applicable Nome Owners Association rules, by aws or an 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 jobsite
before the first inspection. If you Intend to obtain financing, consult with lender or an attorney before
vanf nn t.tt^Alt nr rernrrtina wittr hlntira of f nmmant•am ant
a�2L
a,
Sign ure of Contractor/License Holder
Sign-ature +f Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY Of "51-
COUNTY OF
The forgoing Instrument was acknowledged before me
The forgoing instrumpn was acknowledged before me
tills PI day of ', 20 Ir by
this / f , day of ,�,1Y`1.,L.e .. 20 � by
_ e iL»
U
iil • is
r '� !r•1.f.1
Name of person making statement
Personally Known j/ OR Produced Identification
Name of persorn,making statement
Personally Known ''' OR Produced identification
Type of Identification
Type of identification
Produced
Produced-
(SIgnalure of Notary Public- State of Florida)
(Signature of Notary Public- State of Florida)
Commission No. �baaarvue, RNO a OWE
G 104656
Commission No. _ _ nR, puss (SeAVNI)AS ROVE
* d onunissbn
v� Expires May 19, 2021
Commission # GO 104556
' e . Expires May 19, 2021
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
E
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17