HomeMy WebLinkAboutISLAND DUNES SLC PERMIT APPLICATIONFrom: To:2292087 07/23/2020 09:57 #024 P.0021003
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
'� Ir L5L�1�iJ�
O
�R 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: BOARDWALK
Address: 8735 S OCEAN DR, JENSEN BEACH, FL 34957
Property Tax ID #: 3534-111-0005-000-5
Site Plan Name-
Project Name:
REPLACE BRIDGE ON GOLF CORSE
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit– check all that apply:
,Mechanical _ Gas Tank —Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers ` Generator
Lot No.
Block No.
_ Windows/Doors _ Pond
Total Sq. Ft of Construction: Sq. Ft. of First Floor.
Cost of Construction: $ 26,500.00 Utilities: Sewer
Name ISLAND DUNES COUNTRY CLUB INC
Address: 8735 S OCEAN DR
City: JENSEN. BEACH State: Fr L
Zip Code: 34957 Fax:
Phone No. 772-229-0803
E-Mail:CCKANDI@BELLSOUTH.NET
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
_ Roof Pitch
Septic Building Height:
Name:JOY S YANCY
Company: SUMMERLIN'S MARINE CONSTRUCTION, LLC
Address: 200 NACO RD, #C
City: FT PIERCE State: FL
Zip Code: 34946 Fax: 772-464-7470
Phone No 772-44-6090
E -Ma i I SUMMERLINSMARINECONSTRUCTION@GMAIL.COM
State or County License agL4 Q -I -1
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.
From: To:2292087 07/23/2020 09:58 11024 P-003/003
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: x_ Not Applicable
Name: BENCHMARK ENGINEERING
Name:
Add ress: eos DELAWARE AVE
Address:
City: FT PIERCE State: FL
City: State:
Zip: Phone772-267-13"
Zip. Phone:
FEE SIMPLE TITLEHOLDER: Not Applicable
BONDING COMPANY: x 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. 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 paying twice for
improv ents to your property. A Notice of Commencement must be recorded in the public records of St.
Luci my andposted on the jobsite before the first inspection. If you intend to obtain financing, consult
wi le er or iWattorney before commencing work or recording our Notice of Commencement.
a,�A C
f
Si gnatu relof Owner/ Lessee/Contractor as Agent for Owner
;Sigri*u a of Cont ctor/Licens Holder
. .
STATE OF FLORIDA
STki OF FLORIDA
COUNTY OF _i a
COUNTY OFST LUCIE
Sw to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
.r
Physical Presence or Online Notarization
x Physical Presence or Online Notarization
this Q '4 day of � -% N 2020 by
this �_ day of �L 4 2020 by
[ �s
r1
�- -.2 L)
40
_ 1—Li 3'.`
Name of person making statement.
Name of erson making stateme t.
Personally Known �� OR Produced Identification
CCIZ
Personally Known x OR Produced Identificatio
fli�
Type of Identification
Type of Identification
Produced-
Produced
(Signature of Notary Puhl State of Florida)
(Signature of Wtary Public- State of Florida ) o �+
Commission N KAND►CE D. MO
Commission No. cG33o2s9 (Seal)
Notary Public - State of Florida
Commission q GG 350810
y
.,_
REVIEWS
' d thro
notary ERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW I REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. --
"- PLANNING & DEVELOPMENT
BOARD OF
COUNTY SERVICES DEPARTMENT
COMMISSIONERS I F L : R I . A Building & Code Regulation
CHECKLIST FOR RESIDENTIAL/COMMERCIAL BUILDING PERMIT
Project Location: FrIS J S 0 [,Oa- r\ 'Or. Date:
Permit Number: Technician:
Required Documents:
Application completely filled out with Notarized Signatures ............................. Yes
No
N/A
Sub Agreements with Notarized Signatures (prior to issuance) ..........................
Yes
No
N/AX
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) ................. YesX 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
ApprovedSite 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/A^
Signed Energy Calculations (1 set original signatures & signed in 2 spots) ...........
.Yes
No
N/AX
Ground Sign Landscape Affidavit (signs) ...................................................
Sealed Wind Load Compliance Certification............ ............ . ......................
Yes
No
N/A
Product Review Affidavit.....................................................................
Yes
No
N/AX
Excavatin=„u a pond for fill:
Site plan showing 25-foot(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/AX
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
Other:
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)............
Yes
No
N/AX
Pool Barrier Affidavit..........................................................................
Yes
No
N/AX
Ground Sign Landscape Affidavit (signs) ...................................................
Yes
No
_ N/AX
Burn Rate for Sign Cabinets.................................................................. Yes
No
N/AX
RV and Mobile Home Tie -Down QAIyJ2 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....................................................................................
Yes
No
N/AX
Mobile Home Inspection Report for Relocation (used only)...........................
Yes—No
N/A^
Copy of Title for Relocation (used only) ...................................................
Yes
No
N/AX
Private Property not in a mobile home park v
Class "A" Approval from Planning or file #..... ........................................... Yes No N/A^
COMMENTS
Revised 10/5/18