HomeMy WebLinkAboutBuilding Permit Application BOARD OF PLANNING & DEVELOPMENT
COUNTY SERVICES DEPARTMENT
COMMISSIONERS F LORI . Building & Code Regulation
CHECKLIST FOR RESIDENTIAL/COMMERCIAL BUILDING PERMIT
Project Location: v V4�z& 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
Owner/Builder Affidavit (signed in office)................................................. Yes_No N/A J
Filled Land Affidavit(prior to issuance)......................................................Yes—V No N/A
Recorded Warrany Deed, if applicable....................................................... Yes_No \1 N/A_
Recorded Notice of Commencemement(prior to issuance or inspection)............... Yes No N/A
Utility Agreement or Payment Receipt(prior to issuance)................................. Yes\1 No N/A
Vegetation Removal Application with copy of survey..................................... Yes \1 No N/A
Plans, Calculations & Attachments (3 copies commercial,2 copies residential)
Complete set of plans with Engineer/Architect Raised Seal........................... YesV No N/A
Truss Plans reviewed and approved by Engineer/Architect............................ Yes No N/A_
Landscaping and Parking plan(under 6,000 sgft)......................................... Yes\l No N/A
Approved Site Plans........................................................................... Yes\4 No N/A
Sealed Survey with Dimensions, Finished floor........................................... Yes�l No N/A
Elevations and Setbacks.............................................................. YesNN No N/A
Plot plan with Setbacks............................................................... Yes \J 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
Manual"J"or Manual "N"Calculations................................................... Yes_No_N/A_
Signed Energy Calculations (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....................................................... Yes_No N/A
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 No N/A
Pool Barrier Affidavit.......................................................................... Yes_No_N/A
Ground Sign Landscape Affidavit(signs)................................................... Yes_No N/A_
Burn Rate for Sign Cabinets.................................................................. Yes_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
Manufacture Blocking Documents.......................................................... Yes_No N/A
Signed Penetrometer Test (1 copy)......................................................... Yes_No N/A_
StairDetails.................................................................................... Yes_No N/A
Mobile Home Inspection Report for Relocation(used only)........................... Yes_No N/A
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_
Revised 7/27 18
U
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
- i J _
•
Building Permit Application
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 Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVE ENT LOCAT ON:
Address:
Legal Description:
Property Tax ID#: 0� Lot No.
Site Plan Name: 41 Block No.
Project Name:_ a
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additional work to be i)ertormed under this permit—check all that apply:
F1HVAC Gas Tank Gas Piping _Shutters Windows/Doors
❑Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: C2?(p QJV S . Ft. of First Floor: �?
// a
Cost of Construction: $ .� j `�(p. Utilities: _Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name 1389-VJ Name: JA Al
Address: / Company:
City: State:/✓ Address:J71o,0 _ T Q AiWJ Jout 1B
Zip Code://7792 Fax: City: IV" ,9 Stater
Phone No. Zip Code: ����h/// Fax:
E-Mail:/�iP ,V® / i� 8>Tj �CO�iJ Phone No. /- 79
Fill in fee simple Title Holder on next page(if different E-Mail: v coD' (DyJ
from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER EN,�INE _ of Applicable MORTGAGE COMPANY: _Not Applicable
Name: /�`� 620 9�- s�' Name: '��
Address: Address:
City: State: City: State:
Zip: Phone: — Zip: Phone:
FEE SIMPLE TITLE IJOLDER: _Not Applicable BONDING COMPANP/� 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/Les
se Agent gnature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORID
COUNTY OF COUNTY OF
The fcngoing instr t wa acknowledge4 before me The foygoing instr e t was acknowledged before me
this day of 20 0V by this y day of 20d/ by
(Name of person acknow edging) (Name of person acknowledging')
s'4nu� Ov dw- , '/ jx:t�
(Signature of No ry Pu lc-State of Florida► (Signature of Notar Public-Stat of Florida )
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. Commission No. Notary PtM@§_te of Florida
Notary State of Florida Frances
g� Frances[)Oriza P4y Commission GG 092440
ion GG 092440 r-ores712021
�p fixpires 0712712021
Revised 07/15/201
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS