HomeMy WebLinkAboutpermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 05/12/21 Permit Number:
QCaDU KTrr
L L) � Iz `' L' `� 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:
PROPOSED IMPROVEMENT LOCATION:
AAA-- 10103 Wild Quail DR
Property Tax ID #: 3322-621-0011-000-5 Lot No.2
Site Plan Name: POD 6 PUD 1 AT THE RESERVE WILLOW PINES WEST AT PGA VILLAGE Block No.
Project Name: Joseph R Lamberto
DETAILED DESCRIPTION OF WORK:
CHANGE OUT A/C SYS 3 TDtiI n bEER_ !�
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
Electric Plumbing Sprinklers Generator — Roof
Total Sq. Ft of Construction: _ Sq. Ft. of First Floor:
Cost of Construction: $ 6201 Utilities: —Sewer —Septic Building Height:
Pond
Pitch
OWNER/LESSEE:
CONTRACTOR:
Name Joseph R Lamberto
Name:HOWARD PEARL
Address:10103 Wild Quail DR
Company: PRIDE AC & APPL INC
Port Saint Lucie State:
City: —
Zip Code: 34986 Fax:
Phone No. 772-882-5292
Address:2150 NW 18TH ST?
City: POMPANO BEACH Mate: F
Zip Code: 33069 Fax: 954-9Z7-7715
Phone No954-977-7743
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail PERMITS@PRIDEAC.COM
State or County LicenseCAC052772
If value of construction is 75Q0 or more, a KtwKULIJ NOUCe or %.vm1ncn%cnioen 14V 1=4u••
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: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: — Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:_
Address:
City:_,
Zip:
Pho
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the worK ana insianavon as inuiL;aLcu.
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
structure, conflict
lease consult with your Home Owners AssoAssociation
iation and review your deed for any rests ctions wh ch may alprohibit such
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
b f mew ncin ork or recordingour Notice of C mencement.
with der or an attorrre a ore com
Z7�z , L__
A
Signat re of Owner/ Lessee Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OFBROWARD•
COUNTY OF BROWARD
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
x Physical Presence or Online Notarization
X Physical Presence or Online Notarization
this 10 da f MAY 2020 by
this 10 ay of MAY 2020 by
Name of pe on making statement.
Name of person ma 'ng statement.
Personally Known OR Produced Identification x
Personally Known x OR Produced Identification
Type of Identification
Type of Identification
Produced DAL
Produced
irer StaitetO FI®t1'M*e of Florida
(Signature of No1�1"o
(Signature of Notary U�6 n tee t5# YcSkill�,tate of Florida
erri Jackson
�vf, ri Jackson
Commis i n 133769
Commission No. ices D8/1
a
;_. ,. �My Commis n 1337a9
Commission No. ' expires oai�
U�
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/b/ZU
BOARD OF PLANNING & DEVELOPMENT
COUNTY SERVICES DEPARTMENT
COMMISSIONERS . . Building &Code Regulation
CHECKLIST FOR RESIDENTIAL/COMMERCIAL BUILDING PERMIT
Proiect Location: io /0 2> i!� OR Date: --1 —
Permit Number: Technician:
wired 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) .................................................
Y es
No
N /
_
Filled Land Affidavit (prior to issuance) ...................................................
Yes
No
_ N/A
Recorded Warranty Deed, if applicable......................................................Y
Yes
No
N /
Recorded Notice of Commencement (prior to issuance or inspection) .................
Yes
No
_ N/A
Utility Agreement or Payment Receipt (prior to issuance).................................Yes
No
N/A
—
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
ApprovedSite Plans...........................................................................
Y es
No
/
Sealed Survey with Dimensions, Finished floor ...........................................
Yes —No
—N/A
Elevations and Setbacks..............................................................
Yes
—No —N/A
Plot plan with Setbacks...............................................................
Yes —No—
/
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 ...............................................
YesX
No
N/A
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
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_
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
—N/A
—No
CD for Fire Department if commercial or multi -family ...................................
Yes
—N/A
—No
DEP, SFWMD or Army Corp of Engineers (dock, seawall, SF on beach)............
Yes —No
—N/A
Pool Barrier Affidavit..........................................................................
Yes
—N/A
—No
Ground Sign Landscape Affidavit (signs) ...................................................
Yes
N /
—No—
Burn Rate for Sign Cabinets..................................................................
Yes
—No —N/A
RV and Mobile Home Tie -Down Only (Z 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
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_
COMMENTS
Revised 10/5/18