HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number&l O�II
LUCOG.
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Corrimercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION,
Address: 3100 N Highway Al - Unit 803
Property Tax ID #: 1425-606-0031-000-4 Lot No.
Site Plan Name: Block No.
Project Name: McConnell
DETAILED 'D'ESCRIPTIO,N OF WORK:
Install accordion shutters) 1
New Electrical Meter
Second Electrical Meter.
CONSTRUCTIONS PN.FORMATION:
(Affidavit required)
Additional work to be performed under this permit —check all that apply: '..4.
_Mechanical _ Gas Tank _ Gas Piping X Shutters _ Wipdows/Doors,.,- Pond
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 5820 Utilities: —Sewer _ Septie- Building Height:
OWNERAESSEE: ,
,CONTRACTOR:
Name. Michael McConnell & Marlene Weiss:._ _.._ ..:
Name: Edward J Heritage
Address: Rom Sernunia Ct
ompai y;:.wF'olding Shutter Corporation
City: Indianapolis Stater' I_n- ;
"Address::i�1'862 Dr Martin Luther King Blvd
Zip Code: 46940 Fax: n/a
City: West Palm Reach State: FL
Phone No. 317-366-1982 E-
Zip Code: 33404 Fax: 561-640-8204
Mail: n/a
Phone No 561-683-4811
Fill in fee simple Title Holder on next page (if different
E-Mail info ED-foldingshutters.com
from the Owner listed above)
State or County License SCC131151041
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL, CONSTRUCTION LIEN LAW
INFORMATIOgN
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
BONDING COMPANY: Not 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 conflicts with any, applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Homeowners 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 lender or an attornev before commencing work or recording vour Notice of Commencement.
Signature of Ow es ractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF Palm Beach
Sworn to (or affirmed) and subscribed before me of X Physical Presence or Online Notarization
thisa'Q_ day of 20�Zl by
�dward;`��y�Herita P. ;
Name of personf makhg statement®-�_
Personall Known XXX OR Produced Identification
Typ I ntificatiioon Produced
�
(Signature of Notary Public- State of Florida) Pamela A. Evans
NOTARY PUBLICSTATE
Commission No. (Seal) OF FLORIDA
. Comm* GG262789
Expires 10/11/2022
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev 5/20/21
PLANNING & DEVELOPMENT
BOARD OF
COUNTY SERVICES DEPARTMENT
COMMISSIONERS F L • Building & Code Regulation
CHECKLIST FOR RESIDENTIAL/COMMERCL ,L BUILDING PERMIT
Proiect Location: Jl b0 X5 1+15� WA!j ('�i ! g- 1Vya3 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
Filled Land Affidavit (prior to issuance) ...................................................
Yes
No
_ N/A
Recorded Warranty Deed, if applicable ......................................................Yes
No
N/A
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
No
N/A
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
t
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 —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
PoolBarrier 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
—N/A
—No
Manufacture Blocking Documents..........................................................
Yes
—N/A
—No
Signed Penetrometer Test (1 copy).........................................................
Yes —No
—N/A
StairDetails....................................................................................
Yes
—N/A
—No
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