HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
U L & B� ° ED' _ Building 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:Aluminum With Concrete
PROPOSED IMPROVEMENT LOCATION:
Address: 9018 Pumpkin Ridge Rd Port St Lucie, FL
Property Tax ID#: 3322-505-0147-000-0 Lot No. 138
Site Plan Name: Maidstone Lot 138 Block No.
Project Name: Coppola
DETAILED DESCRIPTION OF WORK:
Form and pour Gt ' ylr '
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
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: Sq. Ft. of First Floor:
Cost of Construction: $ 12,640.00 Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Lydia Coppola Name:Michael J Newman
Address:9018 Pumpkin Ridge Rd Company:Pioneer Screen Co. Inc. II
Port St Lucie Address:1682 SW Biltmore St
City: State:_
Zip Code: 34986 Fax: City: Port St Lucie State.FL
Phone No.462-0250 Zip Code: 34984 Fax: 772-340-4626
E-Mail: Phone No 772-340-4393
Fill in fee simple Title Holder on next page(if different E-Mail pioneerscreen@msn.com
from the Owner listed above) State or County License RX11066919
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: - Not Applicable MORTGAGE COMPANY: _ Yot Applicable
Name: c Name:
Address: b c C 6 Address:
City: State: City: State:
Zip: Phone ' Zip: Phone:
FEE SIMPLE TITLE HOLDER: /Not Applicable BONDING COMPANY: of 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
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 Gu intend to obtain financing, consult
with lender or an a Borne befor 'commencing work or recording r,Notice of Coryxmencement.
Signature of Owner/Lessee/Go trac or as Agent for Owner Signature o Contractor/Lit;ens Holder
STATE OF FLORID STATE OF FLORIDA
COUNTY OF . 1.b -C.-(11� COUNTY OF ',*, .
Sworn to or affirmed)and subscribed before me of Sworn�t -.(or affirmed)and subscribed before me of
y ical Pre ce or Online Notarization �'"Physical Presence or Online Notarization
this d y oifr✓ � t4_1 202d by this `ay of 11 202Q1 by
Name of person making statement. Name of person making statement.
Personally Known 4./ OR Produced Identification Personally Known FOR Produced Identification
Type of Identification Type of Identification
Produced Produced l
(Signature of Notary Public-S Sig ture of tary Public-S
rU� Notary Public State of FI ri
4eaFtrancene Newman / f_�� ( 1 Y ru NotaryPublic State of F4ori a
Commission No. I y Commission GG 221 29om lssion No. �{ ;($�arlene Newman
w n + My Commission GG 22143
os ° Expires 05/2312022 �a
Expires 05/23/2022
REVIEWS FRONT ZONING SUPERVISOR;;; PLANS VEGETATION SEA TURTLE MANGR9,VE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW'-'
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/6/20
BOARD OF PLANNING & DEVELOPMENT
COUNTY . SERVICES DEPARTMENT
COMMISSIONERS' . , A Building & Code Regulation
CHECKLIST FOR RESIDENTIAL/COMMERCIAL BUILDING PERMIT
Pro'ect Location: 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/A V
Owner/Builder Affidavit(signed in office)................................................. Yes No N/A V_
Filled Land Affidavit(prior to issuance) J
......................................................Yes � No N/A
Recorded Warrany Deed, if applicable....:.............. /
..........................:......... Yes �No N/A
Recorded Notice-of Commencemement (prior to issuance or inspection)............... Yes*No t' N/A
—
Utility Agreement or Payment Receipt(prior to issuance).................................Yes No N/A V
Vegetation Removal Application with copy of survey..................................... Yes t/ No N/A
Plans. Calculations &Attachments (3 copies commercial,2 copies residential).
Complete set of plans with Enginper/Architect Raised Seal........................... Yes ✓No N/A
Truss Plans reviewed and approved by Engineer/Architect............................ Yes No N/A
Landscaping and Parkinplan under 6,000 s ft ................. Yes No N/A
Approved Site Plans............................................................................Yes No N/A
Sealed Serve with Dimensions, Finished floor............................................Yes_No ✓ N/A
Elevations and Setbacks.............................................................. Yes No N/A
Plot plan with Setbacks............................................................... Yes v 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................ Yes—No-N/A IJ
Manual "Y'or Manual "N" Calculations.. .......................................... V/.. . Yes No N/�.
Signed EnergyCalculations(1 original signature)..... ... ........................ Yes No N/A
Sealed Wind Load Compliance Certification................................................. Yes - , No—N/A /
Product Review Affidavit................. ......................... . ...................... Yes No N/A +�
Other:
Health Department Permit Paperwork..... L ............................................... Yes_No—N/A
CD for Fire Department if commercial or multi-family.;.................................Yes_No N/A V/
DEP, SFWMD or Army Corp of Engineers (dock, seawall, SF on beach)............ Yes No N/A
Pool Barrier Affidavit......:...................:...........:.................................... Yes No N/A ✓
e
Ground Sign Landscape'Affidavit(signs).. ................................................Yes No N/A
Burn Rate for Sign Cabinets.......... ............................................ . Yes No NIA
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
Manufacture Blocking Documents........................................................... Yes No N/A_
Signed Penetrometer Test(1 copy)......................................................... Yes No N/A
Stair Details. ... ................................................................. Yes_No_N/A_�
c' n used only) Yes No NIA
Mobile Home Inspection Report for Relo aho ( y)...••••-••••••••-•-
Copy of Title for Relocation(used only).................................................... Yes No N/A
Private Property not in a mobile home park
Class "A"Approval from Planning or file#........:....................................... Yes No N/A
COMMENTS
Revised 7/27/18