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COUNTY
Permit Number: Technician:
21 MUM I M aMIMMAI.
Building & Code Regulation
Application completely filled out with Notarized Signatures . ....... . . . .... . . . . . . . . ..... Yes � No N/A
Sub Agreements with Notarized Signatures (prior to issuance) . . . ..... . ..... . ..... . ..... Yes No N/A
Owner /Builder Affidavit (signed in office) .. . ....... . .................. . ..... . . ............ Yes No N/A
Recorded Warranty Deed, if applicable ..... . .................... . ...........................Yes No _ N/A
Utility Agreement or Payment Receipt (prior to issuance) . ................. . . . . . . . . . .. . ...Yes No N/A
Vegetation Removal Application with copy of survey". goo I#& too 4 memo we 9*040494 go *0 me I. mmYesNo N/A
Complete set of plans with Engineer /Architect Raised Seal . ............... . .......... Yes
Truss Plans reviewed and approved by Engineer / Architect, .. . . . .......... 11 . . . ....... Yes No N/AV
Landscaping and Parking plan (under 6,000 sgft). . . ...................................... Yes No N/A
Approved Site Plans,,,,,,,,, of$ motto# 81141tome me. YesNo N/A
Sealed Survey with Dimensions, Finished floor, . ...... . ........ . .....Yes No N/A
Elevations and Setbacks.............................................................. Yes No N/A
Plot plan with Setbacks,,,,,,,,,,,,,, oellootal 0 1 0 V 4 0 o 0 a 6 0 5 ............... . . ...... 1 0.. . Yes No N/A
Health Department approval stamped on survey and floor plan, .. . . . .. . ... . . ..... . . . . . Yes No N/A
Health Department Food Establishment Permit stamped on floor plan, , , save , , Ito ease 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
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Sealed Wind Load Compliance Certification .. . .. . . . ... . . . ..... . . . ............ ... . ease , , ,,, Yes � No N/A
ProductReview Affidavits,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, 0 4 a If 0 1 9 4 1 0 0 0 6 a I a 4 f I # a 0 4 a 0 0 0 9 0 a Yes No IN/
Excavating a pond for fill
Site plan showing 25400t(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
If Hauling fill off site (excess of 100 cubic yards) you must have a mining permit Yes® No N/A V
Health Department Permit Paperwork....................................................... YesNo N/A
CD for Fire Department if commercial or multi®family. ....... . .... . ......... . ........... Yes No N/A
EP SFVMD orArmv Cori) of Engineers (dock seawall SFonbeach),,.,, ev \111ja IT / lk
Pool Barrier Affidavit....................................................................... ... Y es No N/A
Ground Sign Landscape Affidavit (signs) .................... . .............................. Yes No N/A
Burn Rate for Sign Cabinets....., . ............ . . . to . ..... . Yes No N/A
R . and Mobile Home Tie -Down Only . copies)
Permit Worksheet (Tie -Down Diagram) ................................................... Yes No N/A
Manufacture Set -Up and Installation Manual ....................... . .. . .:................. Yes No N/A
Manufacture Blocking Documents........................................................ .. Yes No N/A V RUN
Signed Penetrometer Test (1 copy) ................................ . . ......... . .. . ........ N . Yes No N/A V.
StairDetails.................................................................................... YesNo N/A
Mobile Home Inspection Report for Relocation (used only) ........................... Yes No N/A
Copy of Title for Relocation (used only) ................................................... Yes No
Private Property not in a mobile home park
Class "A" Approval from Planning or file#NNNNN 1 000 9 a 0 Ito It I No at I a No 9 1 1 111 9 1 to It......... Yes No
Revised 10/15/1�