The URL can be used to link to this page

Home My WebLink AboutRevisionPlanning & Development Services Department Building & Regulations Division Product Review Affidavit Building Permit # _____________________ Owners Name _____________________________ Applicant: ___________________________ Product Opening Design Pressures Product Rated Design Pressure Manufacturer Model Number Product Approval Number Glass Type Method of Attachment Windows Mullions Fixed Glass Block Glass Skylights Sliding Glass Doors Swing Type Doors French Doors Garage Doors Hurricane Protection Roof Ventilation Roofing Material I have reviewed the above components or cladding and I have approved their use in this structure. These products provide adequate resistance to the wind loads and forces specified by current code provisions. Name: ___________________________________________ Signature: ___________________________________________ seal Design Prof: ______________________________ Cert. No. _______________________ Date: ________________________ Revised 07/22/2014 1909-0089, 1909-0090, 1909-0091, 1909-0092, 1909-0093 Missionary Flights International RWWDJHV 1R N/AField + 50/-49 Perimeter +55/-55 Corners +100/-89 Field +19.3/-30.6 Perimeter +19.3/-53.3 Corners +19.3/-78.9 By Rational Analysis OFFICE USE ONLY: DATE FILED: _____________________________ PERMIT # _______________________________ REVISION FEE: ___________________________ RECEIPT # ______________________________ PLANNING & DEVELOPMENT SERVICES BUILDING & CODE REGULATION DIVISION 2300 VIRGINIA AVENUE FORT PIERCE, FL 34982-5652 772) 462-1553 APPLICATION FOR BUILDING PERMIT REVISIONS PROJECT INFORMATION LOCATION/SITE ADDRESS: DETAILED DESCRIPTION OF PROJECT REVISIONS: CONTRACTOR INFORMATION: STATE of FL REG./CERT. #: ______________________ ST. LUCIE CO CERT. #: ____________ BUSINESS NAME: _________________________________________________________________ QUALIFIERS NAME: ________________________________________________________________ ADDRESS: _______________________________________________________________________ CITY: _______________________ STATE: _______________ ZIP: _______________________ PHONE (DAYTIME): ________________________ FAX: _____________________________ OWNER/BUILDER INFORMATION: NAME: ____________________________________________________________________________ ADDRESS:__________________________________________________________________________ CITY: _____________________________ STATE: __________ ZIP: __________________ PHONE (DAYTIME: ___________________________ FAX: _____________________________ ARCHITECT/ENGINEER INFORMATION: NAME: ____________________________________________________________________________ ADDRESS: _________________________________________________________________________ CITY: _____________________________ STATE: ____________ ZIP: ___________________ PHONE (DAYTIME): ___________________________ FAX: ____________________________ SLCCC: 9/23/09 Revised 06/30/17 Planning & Development Services Department Building & Regulations Division Product Review Affidavit Building Permit # _____________________ Owners Name _____________________________ Applicant: ___________________________ Product Opening Design Pressures Product Rated Design Pressure Manufacturer Model Number Product Approval Number Glass Type Method of Attachment Windows Mullions Fixed Glass Block Glass Skylights Sliding Glass Doors Swing Type Doors French Doors Garage Doors Hurricane Protection Roof Ventilation Roofing Material I have reviewed the above components or cladding and I have approved their use in this structure. These products provide adequate resistance to the wind loads and forces specified by current code provisions. Name: ___________________________________________ Signature: ___________________________________________ seal Design Prof: ______________________________ Cert. No. _______________________ Date: ________________________ Revised 07/22/2014 1909-0089, 1909-0090, 1909-0091, 1909-0092, 1909-0093 Missionary Flights International RWWDJHV 1R N/AField + 50/-49 Perimeter +55/-55 Corners +100/-89 Field +19.3/-30.6 Perimeter +19.3/-53.3 Corners +19.3/-78.9 By Rational Analysis