HomeMy WebLinkAboutBuilding Permit AppAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
X C) Q.-I
`' L L ` L `2 Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Residential X
PERMIT APPLICATION FOR:Aluminum Without Concrete
PROPOSED IMPROVEMENT LOCATION:
Address: 9401 Portside Dr Fort Pierce, FL 34945
Property Tax ID #: 2310-500-0056-000-0 Lot No.14
Site Plan Name: PALM BREEZES CLUB BLK 2 LOT 14 Block No. 2
Project Name: Lundstroem
DETAILED DESCRIPTION OF WORK:
Install a 28' 3" x 23' aluminum/screen pool enclosure on slab by pool company.
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: $ 9,000.30 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Ulf Lundstroem
Name: Michael J Newman
Address:9401 Portside Dr
Company: Pioneer Screen Co. Inc. II
City: Fort Pierce Stater
Zip Code: 34945 Fax:
Phone No.878-7752
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
IVdRIC u1 cvnsiruction is csuu or more, a KtLUKUtu Notice of commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAVA INFORMATION:
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: Not Applicable
Name: �4iVIA I
Name:
Address: o 5
Address:
City: `-�11.E State: :r
Zip: - Phone i -�,5� '
City: State:
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 recorded iytht publicrecords of St.
Lucie County and posted on the jobsite before the first inspectio you intend tin financing, consult
with lender or an attorne before commencen work or recordl our Notice ofencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signatu of Contract /Lice se Holder
STATE OF FLORIDA
COUNTYOF -W /,, Lu`l i �C
STATE OF FLORID i
COUNTY OF P� ' LLeC-(�'
SwgA to (or affirmed) and subscribed before me of
Sworn or affirmed) and subscribed before me of
�ohical Pres a or Online Notarization
t ,day of — 2021 by
Physical Presence or Online Notarization
this'" day of 2021 by
Name of person making statement.
Personally Known OR Produced Identification V/
Name of person making statement,
Personally Known R Produced Identification
Type of Idecation �p
,PVdu tifi
ed I. V
Type of Identification
Produ d
d
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(Signature of Notary Public- S(i ! f0d§oa )Notary Public State of F
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Commission ea�Qy Commission GG 26
i� Expires 11/13/2022
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653 / `� r r_,[ -r ,ene Newman
Com lion No. C I S . ( ter, ;nrnission GG 2214
c.i`xy�o"ca Expires 05/23/2022
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
s_
RECEIVED
DATE
COMPLETED
ev.
BOARD OF
COUNTY
COMMISSIONERS
PLANNING & DEVELOPMENT
SERVICES DEPARTMENT
Building & Code Regulation
CHECKLIST FOR RESIDENTIAL/COMMERCIAL BUILDING PERMIT
ion: � `� � C�i��/�� � �✓��'i f,,�iQ Date:
Permit Number: Technician:
Required Documents:
Application completely filled out with Notarized Signatures ............................
Yes
VINO
N/A
Sub Agreements with Notarized Signatures (prior to issuance) ..........................
Yes
No
N/A_Z
Owner / Builder Affidavit (signed in office). . ..... , , . . ..... . .... . ......................
, ....
Y es—
No
— N/A 1/
Filled Land Affidavit (prior to issuance)......................................................Yes
No
N/A
Recorded Warrany Deed, if applicable.............................................:.........
Yes
No
N/A V/
Recorded Notice of Commencemement (prior to issuance or inspection) ...............
Yes—
No
NIA
Utility Agreement or Payment Receipt (prior to issuance) ............:....................
Yes—
No
N/A
Vegetation Removal Application with copy of survey.. ...................................
Yes
No
N/A ,J
Plans. Calculations & Attachments (3 copies commercial, 2 copies residential),
Complete set of plans with Engineer / Architect Raised Seal ........................... Yes V No 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—
Approved Site Plans .... . . ....... .............................................................. Y — — Yes— No / N
Sealed Survey with Dimensions, Finished floor......... ....... Yes— No V N/A
..........................
Elevations and Setbacks ... . ............. . ... . .................... . ............... ... Yes No 'J N/A
Plot plan with Setbacks ........ ................................. . ..................... Yes No N/A—
Health Department approval stamped on survey and floor plan ......................... Yes No N/A_J
-
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 (I 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....................................................... Y / Yes Na 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 J
Ground Sign Landscape Affidavit (signs) ................................................... Yes— No N/A
Bum 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 ..................................... ... ................. Y — / — Yes No N A
Signed Penetrometer Test (1 copy)......................................................... Ye
s No N A
Stair Details.................................................................................... Ye — /
s No N A
Mobile Home Inspection Report for Relocation (used only) ........................... Yes No — NIA
Copy of Title for Relocation (used only) ................. ..................... I............ Yes No N/A
Private Property not in a mobile home park
Class "A" Approval from Planning or file4 ................................................ Yes No N/A_
COMMENTS
Revised 7/27/18