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Home My WebLink AboutHARSCH PERMIT APPLICATION AND CHECKLISTAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: S�U. ILLFUE�,-,w AL P L o) L LBuilding Permit Application Planning and Development Services Building and Code Regulation Division Commercial Residential X 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR -BOAT Ll T PROPOSED IMPROVEMENT LOCATION: 11995 S INDIAN RIVER DR, JENSEN BEACH Addres . I Property Tax ID #: 3532-802-0014-000-6 Site Plan Name: Project Name-, DETAILED , DES , C , R , I "PTI, ON OF WORK-' . .... ... . ... .. . INSTALL BOAT LIFT - ELECTRIC ON SEPARATE PERMIT SLC 006-0919 New Electrical Meter Second Electrical Meter Additional work to be performed under this permit- check all that apply: —Mechanical — Gas Tank —Gas Piping — Shutters Windows/Doors Pond — Electric — Plumbing — Sprinklers — Generator — Roof Pitch Total Sq. Ft of Construction: Cost of Construction: $ 9,379.00 'OWNERAESSEE: Name ROBERT HARSCH Address. PO BOX 13051 City: FT PIERCE State: Sq. Ft. of First Floor: Utilities: —Sewer _Septic CONTRACTOR. Name:JOY S YANCY Building Height: . . . .. .. ........ Company: SUMMERLIN'S MARINE CONSTRUCTION Address:200 NACO RD #C Zip Code: 34979_Fax: City: FT PIERCE - State: FL Phone No. 321-228-8892 .. . .... Zip Code: 34946 72-46 Fax: 74-7470 E -Mail: BOBHARSCH@YAHOO.COM Phone No772-464-6090 Fill in fee simple Title Holder on next page ( if different E -Mail SUM MERLINSMARINECONSTRUCTION@GMAIL.COM from the Owner listed above) State or County License 24217 If value of J ..... . ....... . . . . . . ............ lion ii -i5_06 -or, more,a- R—E-C-O-, R,D***,E*,**D--"N'-o—ti-c-e-o-f, Commencement is required. If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required. DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Name: HI -TIDE BOAT LIFTS Name: Address: 4050 SELVITZ RD Address: City: FT PIERCE State: FL City: Zip: 34981 Phone7724614660 Zip: Phone: FEE SIMPLE TITLEHOLDER: Name: Address: City: Zip: Phone:— — Not Applicable Not Applicable State: BONDING COMPANY: Not Applicable Name: Address: city:_ 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. LucieCO un makes no representation that is granting a permit will authorize the permit holder to build the subject structure which is in c 0 Act with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such n 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 improvements to your property. A Notice of Commencement must be recorded in the public records of St. Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult with ler _ide ran attorney before commencing work or recording _yqur Notice of Commencement. ........ . ... . ....... ........ ... . . . ... . . .. . . . ... . . . ....... . . . ............... signa tire 01 e/Contractor as Agent for Owner of Canty lor/1--icen a Holder STATE OF FLORIDA STAT OF FLORIDA COUNTY OF —hrj�►n COUNTY OF L -L4 G I -9— Sworn to (or affirmed) and subscribed before me of sical Preseriaor, _ Online Notarization i 'F this.day of_ j L, 2020 by � * J 1 Namelof person making statement. Personally Known OR Produced identification Type of Identification ry Commission No. REVIEWS ----- S DATE RECEIVED DATE COMPLETED C-1 J%TAN ESPINOSA Notar - State of Florida Commission # GG 267068 Sworn to {or affirmed) and subscribed before me of xPq sical Presence or Online Notarization this � day of _ E 2 t i 2020 by JOY 8 YANCY Name of person making statement. Personally Known x OR Produced Identification Type of Identification Produced (Signature of rotary Commission No. GG 330259 SI0;1 FWftRublic State of Florida Hester MY Cmmission GG 330259 ;&@W)/2023 FRONT -20NING SU-P—ER—VISOR I PLANS VEGETATION SEA TURTLE MANGROVE COUNTER I REVIEW I REVIEW i REVIEW REVIEW REVIEW REVIEW . ......... .. . . . . . . . . . . ........ ......................... ..... BOARD OF T77� PLANNING & DEVELOPMENT COUNTY SERVICES DEPARTMENT COMMISSIONERS F L . R I ■ A Building & Code Regulation CHECKLIST FOR RESIDENTIAL/COMMERCIAL BUILDING PERMIT Project Location: ; r s I �_!l ilk" 'Df Date: S • i q � D Permit Number: Technician: Required Documents: Application completely filled out with Notarized Signatures............ ................ YesX No—N/A— Sub oN/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 V Recorded Warranty Deed, if applicable ......................................................Yes No N/A 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[IIIAV 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/AX Signed Energy Calculations (1 set original signatures & signed in 2 spots) ........... .Yes No N/AX Sealed Wind Load Compliance Certification............................................... Yes No N/AX Product Review Affidavit..................................................................... Yes No N/AX Excavatin4, a [gond for fill: Site plan showing 25-foot(minimum) set back from all property boundaries, size, Yes_ No_ N/AX 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_ MAX 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)............ YesX No N/A PoolBarrier Affidavit......................................................................... Yes No N/AX Ground Sign Landscape Affidavit (signs) ................................... ............... Yes No MAX Burn Rate for Sign Cabinets.................................................................. Yes No N/AX RV and Mobile Home Tie -Down Only (2 copies) Permit Worksheet (Tie -Down Diagram) ................................... , ............... Yes No N/A^ 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/AX Stair Details.................................................................................... Yes No N/AX Mobile Home Inspection Report for Relocation (used only) ........................... Yes—No N/AX Copy of Title for Relocation (used only) ................................................... Yes No N/Ax Private Property not in a mobile home park X v Class "A" Approval from Planning or file #........... ................................... Yes No N/A COMMENTS Revised 10/5/18