HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
ccclnc��.M
Permit Number:
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 X
PERMIT APPLICATION FOR:Aluminum without concrete
PROPOSED IMPROVEMENT LOCATION:
Address: touu i apaya Ur Fort Pierce, FL 34982
Property Tax ID #: 3402-610-0286-000-4
Site Plan Name: INDIAN RIVER ESTATES UNIT 09 -BLK 79 LOT 21
Project Name: Groendyke
Lot No. 21
Block No. 79
DETAILED DESCRIPTION OF WORK:
Install a 45' x 22' aluminum/screen pool enclosure on existing deck. PEPLPC11JG EKI STING 0NccoSo(Zt'
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
Electric _ Plumbing _ Sprinklers Generator
Total Sq. Ft of Construction:
Cost of Construction: $ 12,640.00
Sq. Ft. of First Floor:
Windows/Doors Pond
_ Roof Pitch
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Jerry Groendyke
Address: 5808 Papaya Dr
Name: Michael J Newman
Company: Pioneer Screen Co. Inc. II
City.. Fort Pierce State:'lT�
Zip Code: 34982 Fax:
Phone No. 418-7506
Address: 1682 SW Biltmore St
City: Port St Lucie State: FL
Zip Code: 34984 Fax: 772-340-4626
Phone No 772-340-4393
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail pioneerscreen@msn.com
State or County License RX11066919
. — — vI—.. YUL VI1 3 L uv UI 11 lute, d rict unucu nonce or l..ommencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
`bUFFLLIVIENIALCONSTRUCTION LitN LAV'tr` iNF€3RtVtAT(C3N: -1
DESIGNER/ENGINEER: — Not Applicable
MORTGAGE COMPANY: Not Applicable
Name: �oKim&associates Name:
Address: Po Box 10039 Address:
City: Tampa State: FL City: State:
Zip: 33679 Phone 813-857-9955 Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
Not Applicable
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
of Applicable
UvvlmtK/ LUN 1 KAL I UK 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 your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first ins ctian. if you in , d to obtain financing, consult with lender_or an attorne before
comme5 wo "r recording yo Notice of Commencement �'
! f
r
Signature of
STATE OF FLORIDA
COUNTY OF Saint Lucie
ctor as Agent for Owner I Signature
The forgoing instr m nt was acknowledged before me
this _4�'?"day of 20 by
Michael J Newman
Name o prson making statement
Personally Kn n 1 ice' OR Produced Identification
Type of IdentAica on j7
{Signa re of NotaIPubIi
q AyRL, Notary Public State of Florida
Commission No. GG221434, ; Frdj$�Wl Newman
My Commission GG 221434
Lorna Expires05/23/2022
ctor/Licen0e Hol
STATE OF FLORIDA
COUNTY OF Saint Lucie
The for wing instr m nt was acknowledged before me
this day of i 26,& by
Michael J Newman
Name of person making statement
Personally Known ✓�`` OR Produced Identification _
Type of Identifi tion r' j
re of Notary P ty "
v a Notary Public State of Florida
;ion No. GG22 34r°� '� Francene��eyl z21434
My Comm? �6
Expires O5/23I202
FV
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
I COMPLETED
I
I
Rev. 8/2/17
PLANNING & DEVELOPMENT
BOARD OF SERVICES DEPARTMENT
COUNTY
COMMISSIONERS F L . R I • Building & Code Regulation
CHECKLIST FOR RESIDENTIAL/CONIM ERCIAL BUILDING PERMIT
i ,4' a ,lit i"�'f' e e Date: '3A '�
Permit Number: Technician:
Required Documents:
Application completely filled out with Notarized Signatures ............................. Yes /No NIA
Sub Agreements with Notarized Signatures (prior to issuance) .......................... Yes No NIA
Owner / Builder Affidavit (signed in office) ................................................. Yes No N/A
Filled Land Affidavit (prior to issuance)......................................................Yes No NIA
Recorded Warrany Deed, if applicable.............................................:......... Yes—, No N/A
Recorded Notice -of Commencemement (prior to issuance or inspection) ............... Yes- No — N/A_
j
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 & Attachments ( 3 copies commercial, 2 copies residential).
Complete set of plans with Engineer / Architect Raised Seal ........................... Yes VINO N/A
Truss Plans reviewed and approved by Engineer / Architect ............................ Yes No N/A V/.
Landscaping and Parking plan (under 6,000 sgft)........................................
Yes
No
_ N/A
Approved Site Plans. .....................................
Yes_
No
/
N/A J
Sealed Survey with Dimensions, Finished floor ............................................
Yes
No
✓ N/A
Elevations and Setbacks... ............................................................
Yes
No
t/ N/A
Plot plan with Setbacks...............................................................
Yes v/
No
N/A
Health Department approval stamped on survey and floor.plan......................... Yes No . NIA
Health Department Food Establishment Permit stamped. on floor plan..... I ....... 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 t/
Product Review Affidavit ................................ ......... .................. ........... Yes No N/A V
Other:
Health Department Permit Paperwork....................................................... Yes No NIA
CD for Fire Department if commercial or multi -family ....................... Yes No NIA v
DEP, SFWMD or Army Corp of Engineers (dock, seawall, SF on beach)............ Yes No
N/A V
Pool Barrier Affidavit ....................................................................... Yes— No
— N/A 1�
Ground Sign Landscape Affidavit (signs) ................................................... Yes No
NIA
Burn Rate for Sign Cabinets.................................................................. Yes No
NIA V
RV and Mobile Home Tie -Down Only (2 copies)
Permit Worksheet Tie -Down Diagram) .................. Yes No N/A V
Manufacture Set -Up and Installation Manual ............................................... Yes No N/A ✓
Manufacture Blocking Documents.......................................................... Yes No N/A t0
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_Z
Private Property not in a mobile home park
Class "A" Approval from Planning or file # ................................................ Yes No NIA
COMMENTS
Revised 7/27/18