HomeMy WebLinkAboutApplicationALI. APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
n Col 61i . V (9, Ir -1(11 �' 1, °, [p) C; n is 0
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial f�c� I(�<�I1i l0I ��_
PERMIT APPLICATION FOR: Boat lift / Dock Ext.
PROPOSED IMPROVEMENT LOCATION:
Address: 48 NETTLES BLVD.
Legal Description: NETTLES ISLAND INC, A CONDO -SECTION II PARCEL 48 AND PRORATA SHARE IN COMMON ELEMENTS
Property Tax ID #: 4502-501-0234-000-0 Lot No.
Site Plan Name: LOHMEYER Block No.
Project Name: LOHMEYER-DOCK / BOAT LIFT —
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
1. FURNISH AND INSTALL 1 PC. 80 +/- SQ FT DOCK EXTENSION AND 1 PC.EOAT LIFT
CONSTRUCTION INFORMATION:
Zm
itrona wor < to a er orme un er t is permit — c ec c a apply:
HVAC 01 Gas Tank ❑Gas PipingShutters I=-. Windows/Doors
Electric lumbingSprinklers [:]Generator I Roof Roof pitch
11 0 P
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 18 000.00 Utilities: Sewer E]Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name CHRISTINE & DAVID LOHMEYER
Address: 15980 SW 13TH STREET
City: PEMBROKE PINES State: FL
Zip Code: 33027 Fax: N/A
Phone No. 954-410-2517
Name: ROBERT WILLIAMS
Company: WILCO CONSTRUCTION INC
Address: 10751 ORANGE AVE
City: FORT PIERCE State: FL
Zip Code: 34945 Fax: 772460-6929
E -Mail: N/A
Phone No. 772-460-6928
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 $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
FRONT
MORTGAGE COMPANY: X Not Applicable
Name: DANIEL PAUL RETHERFORD
PLANS
Name:
Address: 1402 HARTMAN RD
MANGROVE
Address:
City: FORT PIERCE State: FL
REVIEW
City: State:
Zip: 34947 Phone: 772-224-9826
REVIEW
Zip: Phone:
REVIEW
FEE SIMPLE TITLE HOLDER: X Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
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 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 our Notice of Commencement.
--- s
Signature of Owner/Lessee/Contractor as Agent for Owner r Signature of Contr ._ ense Holder
STATE OF FLORIDA w � STATr, OF FLORID I '
COUNTY OF �l lJl l�'`� COUNTY OF U%kLA.,A
The fo oing instrument was acknowledge efore me The forgoing instrument was acknowledge before me
this ay of 20�by this�ay of _ 20by
R69601- UVI Ilk I idm� zj'� W(J
(Name of person acknowledging) (Name of person acknowledging )
DOLD cc&_ TAU_� -
(Signature of Notary Public- State of Florida) (Signature of Notary. Public- State of Florida
`� )
Personally Known OR Produced Identification Personally Known ✓ OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. - Commission No.
,�YP..�•. DAW ERALD Fldu DAWN FITZG RALD
MY COMMISSION # GG 162348 - _�' MY COMMISSION # GG 162348
PAI EXP ecem er o EXPIRES: December
,;— ' Bond( Thnr Noi3ry Public Underwrilars nor-vt4 ' Bonded Thru Notary Pub!IC Underwiters
Revised 07/15/2014- -- L_'_�••����
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
BOARD OFST. LC.tCIEPLANNING & DEVELOPMENT
SERVICES DEPARTMENT
COUNTY
COUNTY
COMMISSIONERS F L O R I D ABuilding & Code Regulation
O. RESIDENTIAL/COMMERCIAL BUILDING PERMIT
Project Location: 48 NETTLES BLVD. - LOHMEYER Date:
Permit Number: Technician:
Reguired Documents:
Application completely filled out with Notarized Signatures ............................ Yes VNo N/A
Sub Agreements with Notarized Signatures (prior to issuance) ..........................
Yes
VNo ®
N/A
Owner / Builder Affidavit (signed in office) .................................................
Yes
No
N/A
V
Filled Land Affidavit (prior to issuance) ................................................... Yes No N/A V
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).................................Yes No N/A
Vegetation Removal Application with copy of survey.....................................Yes No N/A V
Plans, Calculations 8 Attachments ( 3 copies commercial, 2 copies residential)
Complete set of plans with Engineer / Architect Raised Seal ........................... 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 V
Approved Site Plans........................................................................... Y /
es No N A
Sealed Survey with Dimensions, Finished floor ........................................... Yes No N/A
Elevations and Setbacks.............................................................. Y /
es No N A
Plot plan with Setbacks............................................................... Yes—No/
N A
Health Department approval stamped on survey and floor plan ........................
Yes—No—N/A
No
N/A V
Health Department Food Establishment Permit stamped on floor plan ..... . ..........
Yes—No—N/A
No
V
Manual "J" or Manual "N" Calculations....................................................
Yes
No
N/A V
Signed Energy Calculations (1 set original signatures & signed in 2 spots) ...........
.Yes
No
N/A
Sealed Wind Load Compliance Certification ...............................................
Yes VNo
N/A
ProductReview Affidavit.....................................................................
Yes
No
N/A
Excavating 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/A V
Depth of excavation does not exceed 12 feet in depth .................................... Yes No® N/A V
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 .................................. I ....................
Yes
No
N/A V
CD for Fire Department if commercial or multi -family ...................................
Yes
No
N/A
DEP, SFWMD or Army Corp of Engineers (dock, seawall, SF on beach)., ..........
Yes VNo
N/A
Pool Barrier Affidavit..........................................................................
Y es
No
N A
/
Ground Sign Landscape Affidavit (signs) ...................................................
Yes
No
N/A V
Burn Rate for Sign Cabinets..................................................................
Y es
No
/
N A
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/A V
Manufacture Blocking Documents.......................................................... Yes—No—N/A V
Signed Penetrometer Test (1 copy)......................................................... Yes—No—N/A V
Stair Details....................................................................................
Y es
No
N A
/
Mobile Home Inspection Report for Relocation (used only) ...........................
Yes—No—N/A
V
Copy of Title for Relocation (used only) ...................................................
Yes
No
N/AV
Private Property not in a mobile home park
Class "A" Approval from Planning or file # ................................................ Yes No N/A
Revised 10/15/18
PERMIT i
ISSUE DATE
nqo9vY
D A
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance DivHoro
LI rc—T✓F C-
Name/Individual Name)
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
Ses v/'r G Tit, L have agreed to be
the FI FrTRIrAI Sub -contractor for WILCO CONSTRUCTION INC.
(Type of Trade) (Primary Contractor)
For the project located at 48 NETTLES BLVD. - LOHMEYER RES.
(Project Street Address or Property Tax ID #)
It is understood. that, if there is any change of status regarding our participation with the above mentioned
project, the Building and Code Regulation Division of St. Lucie County will be advised pursuant to the
filing of a Change of Sub -contractor notice.
CON9'RAC:'I'OR SIGNA'I'UItr ( nnlili
ROBERT WILLIAMS
PRINT NAAIE
29115
COUNT%' CERTIFICATION NUMBER
simenrFloridn,Counfyof ST I_UCIE
The foregoing InsU•nincnl was signed before me Ihlw� day of
_s , 211jLpi,•
u Im is persounlly Imnu n V<1 has produced 11
ns ldenlificnli11n.
STAMP
Signnlore of Nolory Public
111.1111 N11111e ol'Noln I'
�,sv,ry DAWN FlTZGERALD
MY COMMISSION # GG 162348
EXPIRES: December 17, 2021
Bonded 711111 Notary Public Underwriters
Revised I I/IG/) Ifi
d;&�
.90R- NTRAC1'OR SIGNATURE (Qunlilier)
UZI /Z L -4
PRINT NAME
oz 9 y 3 -)_
COUNT%' CERTIFICATION NUMBER
state of Fiorillo, County or
The furegning brslrunienl wns sig�ned� her�ure'^me 011stt_- of
2tl ply LLw
who Is personally Immvnf✓ ',.11115 produced it
as IdenllRcnlimi.
T\A � Auwwow STAMP
sipTrilre of Nolurq Public
Print Name of Notary Public
DAWN FITZGERALD
MY CObiMI SSION # GG 162348
`' ;: o•=
EXPittES; December 17, 2021
fivnded fbnl Notary Public Underwriters