HomeMy WebLinkAboutWIECKS PERMIT APPbQAKLJ •
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Building & Code Regulation
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PiOiectLoCation: 120 QUEEN ELIZABETH CT (WIECKS) Date:
Permit Number: Technician:
''•r •r l � r .
Application completely filled out with Notarized Signatures . .................. a , ....... Yes No N/A
Sub Agreements with Notarized Signatures (prior to issuance) ...... .. . ...... 0 , ... , ..... Yes No ® N/A �0
Recorded Warranty Deed, if applicable ................................................ . .....Yes No _ N/A
Recorded Notice of Commencement (prior to issuance or inspection) . . .. . . ... . . ...... Yes No N/A
Utility Agreement or Payment Receipt (prior to issuance). 0 9 4 YesNo N/A
Vegetation Removal Application with copy of survey .. ...................................Ycs No N/A
Plans, Calculations �i Attachments (3 copies commercial, 2 copies residential)
Complete set of plans with Engineer / Architect Raised Seal. . a 4 6 0 6 1 0 t 0 0 9 e a 1 0 4 6 a a # e 0 9 . Yes VNo N/A
Truss Plans reviewed and approved by Engineer / Architect, ........................... Yes No N/A
Landscaping and Parking plan (under 6,000 sgft)................................. . ....... Yes No ® N/A
Approved Site Plans........................................................................... Y / es No N/A
Sealed Survey with Dimensions, Finished floor .. . ........ . ..................... . ......... Yes No N/A
Elevations and Setbacks......................................................... . .... Ye
s No N/ A
Plot plan with Setbacks... . ............ Yes No N/A
Health Department approval stamped on survey and floor plan, . 6 a * 4 * a a $ b 1 0 8 6 1 0 6 0 a 6 a 6 . YesNo N/A
Health Department Food Establishment Permit stamped on floor plan ................ Yes No N/A
Manual "J" or Manual "N" Calculations . . ....... . .... . .................. . .......... . ....... Yes No N/A
Signed Energy Calculations (1 set original signatures & signed in 2 spots). , ..........Yes No N/A
boo
Sealed Wind Load Compliance Certification., ,, 1 00 0 the 0 1 6 bo# 0 so 0#00 . . . ..................0 Yes VNo N/A
ProductReview Affidavit ......................... . .... . .... . . .... . .... . . . ...... . ...... 0 , ..... Yes No IN
Excavating a pond for fill:
Site plan showing 25afoot(minimum) set back from all property boundaries, size, Yes,_ No N/A�
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 N/A
® here
Health Department Permit Paperwork ........................................ . ..... ......... Yes No N/A
DEP, SFWMD or Army Corp of Engineers (dock, seawall, SF on beach)„ . , ........ Yes \/No N/A
Pool Barrier Affidavit, 61 4 Yes No N/A V
Ground Sign Landscape Affidavit (signs) ................................................... Yes No N/A
MAIdVoms
Burn Rate for Sign Cabinets...... . .......... ............................................ Yes No N/A
RV and Mobile Home Tie -Down Onl�(2 it
Permit Worksheet (Tie -Down Diagram) ................................................... Y / es No N A
Manufacture Set -Up and Installation Manual......... toga to 1 00040 to 0 0 to at* I of too ago to *4 Yes No N/A V.
Manufacture Blocking Documents ......................... .... ,. Yes No N/A V ago
Signed Penetrometer Test (1 copy) ............................................ . ......... . .. Yes No N/A
V.
StairDetails .................................................... . .............................. 0 Y / es No N A
Mobile Home Inspection Report for Relocation (used only) ........................... Yes No N/A
Copy of Title for Relocation (used only) .................................................
Private Property not in a mobile home park
Class "A" Approval from Planning or file # ................................................ Yes No
Revised 10/15/1�
AH. APPLICABLE INFO MUST BE COMPLETED FOR APPLICA 1 ION TO BE ACCEP i FD
Date: Permit Number:
Planning and Development Services
tuilding and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 ��
Commercialc Residential
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Dock/Seawall
PROPOSED IMPROVEMENT LOCATION:
Address: 120 QUEEN ELIZABETH CT, FT PIERCE, FL 34949
Legal Description: QUERNS COVE - UNIT 1 - BLK 8 LOT B
Property Tax ID #: 1414401-0065-000-9 Lot No.
Site Plan Name: WIECKS Block No.
Project Name: WIECKS - SEAWALL / DOCK
Setbacks Front Back: Right Side: Left Side:
I fl I AILED DESCRIPTION OF WORK:
1. REPLACE EXISTING 180 +/- SQ FT DOCK IN SAME LOCATION
2. INSTALL A NEW SEAWALL WITI-IIN 18" WETFACE TO WETFACE OF EXISTING
CONSTRUCTION INFORMATION:
itiona wor c to a er orme un er t is permit — c ecic a apply:
❑HVAC 0 Gas Tank ❑Gas Piping _ Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 34,000000 Utilities: Sewer []Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name CHRISTOPHER WIECKS
Name: ROBERT WILLIAMS
Address:120 QUEEN ELIZABETH CT
Company: WILCO CONSTRUCTION INC
City: FT PIERCE State: FL
Address: 10751 ORANGE AVE
Zip Code: 34949 Fax: N/A
City: FORT PIERCE State: FL
Phone No. 631 -523-2292
Zip Code: 34945 Fax: 772460-6929
E-Mail: MWIECKS@AOL.COM
Phone No. 772460-6928
E-Mail: WILCOINC@BELLSOUTH.NET
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
State or County License: SCC131151026 29115
If value of construction is $250D or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name: DANIELPAULRETHERFORD
Address: 1402 HARTMAN RD
CItV: FORT PIERCE
Zip: 34947 Phone: 772-224-9326
Not Applicable
State: F�
FEE SIMPLE TITLE HOLDER: X Not Applicable
Name: _
Address:
City:
Zip:
Phone:
MORTGAGE COMPANY: X Not Applicable
Name.
Address:
City: State:
Zip: Phone:
BONDING COMPANY:
Name: _
Address:
City:_
I certify that no work or installation has commenced prior to the issuance of a permit.
Phone:
Not Applicable
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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work.or recording your Notice of Commencement.
Signature
as Agent for Owner
Signature of Contra
nse Holder
STATE OF FLORIDA r A. STATE OF FLORIDA
COUNTY OF l COUNTY OF A WL!�
The forgoing instrum a s acknowledgefore me The forgoing instr t was acknowled fore me
this ay of 20LAW01uy thisay of 20 by
Ll ms
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Pubes State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
-.— -- ZCERAL ea
•• ,, MY COMMISSION # GG 162348
•- _ Xp k T f�ecemFil�l tt—
+r�!L �'c`c [ o ded'rhnl Notary Public rs
Unde"nita
Revise 6* All 9 4-- --
Commiss
(Signature of Notary Pu/blic-State ofFlorida )
Personally Known �/ OR Produced Identification _
Type of Identification Produced
Commission No. DAWPi I 5�D7
MYCOMMI; MON # GG 162348
Bonded
Thru Notary Pubic. Undorwriters
E
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