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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date Permit Number: o ° n Building Permit Application Planning and Development Services Building and Code Regulation Division Commercial Residential 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: PROPOSED IMPROVEMENT LOCATION: Address: '7-0:Z --Qdl & h ©cam 3 - z Ll Property Tax ID #: 34 IQ - 2)Z 00/ q/ - 0(30 C% Lot No. � Site Plan Name: Block No. Project Name: aIC4 -SCle it., L, > f DETAILED DESCRIPTION OF WORK: r0, 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 Total Sq. Ft of Construction: sr Cost of Construction: $SL�' .�t,��LG Generator L,--R o o f ! IQ Pitch Sq. Ft. of First Floor: Utilities: —Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name g & 24 Cdr Name: 11 Address:2-riz &ST A ho,- Company: 57�yi­' � v (nYS7/iruC ?0 City: ��� Lit ei'G State: - Addres,.,s� %OS72 S. US" HUiY 1 57� s'C8 Zip Code: iC�� Fax: /11�d4 City: \J ! v State: f L Phone No. /7-7� ZZ�i - PeV9 Q Zip Code: .W 77 Fax: Phone $`/ -70 /- E-mail: ric Fill in fee simple Title Holder on next page ( if different E-Mail ur.SG • C o �1 ��J)e'v from the Owner listed above) State or County License rG /3323Y F If value of construction is 2500 or more, a RECORDED Notice of Commencement is requirea. 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 Name: Address: City: State: Zip: Phone MORTGAGE COMPANY: _ Not Applicable Name: Address: City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: Address: BONDING COMPANY: Not Applicable Name: 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 you intend to obtain financing, consult With Ipnripr nr an attnrnPv hefnre cnmmencinLy work or recordinia vour Notice of Commencement. Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF ONyyli, 96rr_ c n Swo�to (or affirmed) and subscribed before me of Swo to (or affirmed) and subscribed before me of Notarization �0 Physical Presence or Online Notarization Physical Presence or Online this S day of AeAN�. , 204erby this $ dayy1o�f, Aflr;\ 2(11 by nr�iS Y1 f ��MG►� �vt�Vl�G.� �'' _� Name of person making statement. Name of person making ment. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced (Signature N tar ubli - tate of Si natu e N tar Pu c- ate f For' �p�✓' w Notary Public State Commission No. �J; Kristin Cury My Commission HH f F onda o`er"� !r�}pplary Public Slate of FI Ctommis 'on No. ? laecKl'islin Cury 05141 y My Commission HH 005 p� '10� M1d• Expires 05/31/2024 "Oao Expires 05/3112024 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 5/6/20 BOARD OF PLANNING & DEVELOPMENT COUNTY SERVICES DEPARTMENT COMMISSIONERS Building & Code Regulation CHECKLIST FOR RESIDENTIAL/COMMERCIAL BUILDING PERMIT 'n 4`1'1� �� Date: 0 i�oy 1 Project Location: 2C'?`7 1✓�6+ 1�✓Uj° Permit Number: Required Documents: Technician: Application completely filled out with Notarized Signatures ............................ Yes No N/A Sub Agreements with Notarized Signatures (prior to issuance) .......................... Yes J No _ N/A Owner / Builder Affidavit (signed in office) ................................................. Yes I✓ No N/A Filled Land Affidavit (prior to issuance) ................................................... Yes No N/A t/ Recorded Warranty Deed, if applicable ......................................................Yes No N/A Recorded Notice of Commencement (prior to issuance or inspection) ................. Yes k/ No N/A Utility Agreement or Payment Receipt (prior to issuance).................................Yes No _ N/A V_ u� Vegetation Removal Application with copy of survey.....................................Yes No N/A Plans, Calculations & Attachments ( 3 copies commercial, 2 copies residential) Complete set of plans with Engineer / Architect Raised Seal ........................... Yes —No —N/A Truss Plans reviewed and approved by Engineer / Architect ............................ Yes —N/A —No Landscaping and Parking plan (under 6,000 sgft)......................................... Yes No _ N/A Approved Site Plans........................................................................... Yes —No —N/A Sealed Survey with Dimensions, Finished floor ........................................... Yes —No —N/A Elevations and Setbacks ................................................... . .......... Yes —No —N/A Plot plan with Setbacks............................................................... Yes 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 set original signatures & signed in 2 spots) ........... .Yes_No N/A Sealed Wind Load Compliance Certification ............................................... Yes —N/A —No Product Review 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 p g ( ) P P Y 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 Depth of excavation does not exceed 12 feet in depth .................................... Yes No— N/A p - If Hauling fill off site (excess of 100 cubic yards) you must have a mining permit 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 V RV and Mobile Home Tie -Down Only (2 copies) Permit Worksheet (Tie -Down Diagram) ................................................... Manufacture Set -Up and Installation Manual .............................................. Yes —No Yes —No —N/A V/ —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 V Private Property not in a mobile home park / Class "A" Approval from Planning or file # ................................................ Yes No N/A�✓ COMMENTS Revised 10/5/18