HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: L� 1 a Permit Number: a\ Oy
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
PERMIT APPLICATION FOR: Dock/Seawall��—f-
PROPOSED IMPROVEMENT LOCATION:
Address: 135 PARLIAMENT CT, FORT PIERCE, FL 34949
Legal Description: QUEENS COVE - UNIT 1 -BLK 17 LOT D
Property Tax I D #: 1414-701-0161-000-2
Site Plan Name: RAMSAY
Project Name: RAMSAY
Setbacks Front Back: _
DETAILED DESCRIPTION OF WORK:
Right Side: Left Side:
RECEIVED
APR 19 2021
rprmittirg Department
Sc. Lucie County
Residential X
Lot No.
Block No.
f iA vril Sh -6 1n5tci(( L.p -fo 110 L. F-h 0+ V OLI I cS�au- I
RQMove Exislhn9 Duui! I &DO4-k74+
1 nS I I vu 600+ 04-�.
CONSTRUCTION INFORMATION:
ition wa ork to be ertormed under this permit — check all that apply:
❑HVAC
Gas Tank
Gas Piping
Shutters
❑
Windows/Doors
❑
Electric
❑
Plumbing
❑
Sprinklers
Generator
Roof
Roof pitch
Total Sq. Ft of Construction:
Q
Cost of Construction: $ F3 j cm, 00
S Ft. of First Floor: _
Utilities: Sewer Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name RAMSAY, BARBARA & STEPHEN
Name: ROBERT WILLIAMS
Address: 135 PARLIAMENT CT
Company: WILCO CONSTRUCTION INC
City: FORT PIERCE State: FL
Zip Code: 34949 Fax: NIA
Phone No. 631-334-4845
Address: 10751 ORANGE AVE
City: FORT PIERCE State: FL
Zip Code: 34945 Fax: 772-460-6929
Phone No. 772-460-6928
E-Mail: WILCOINC@BELLSOUTH.NET
E-Mail: NIA
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License: SCC131151026 29115
If value of construction is $2500 or more, a RECORDED Notice of Commencement is requirea.
, M-
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: X Not Applicable
Name: DANIEL PAUL RETHERFORD
Name:
Address: 1402 HARTMAN RD
Address:
City: FORT PIERCE State: FL
City: State:
Zip: 34947 Phone: 772-224-9826
Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
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 inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
s
SignatureOwner/Lessee/Contractor as Agent for Owner Signature of ontractor/License Holder
STATE OF FLORIDAy�r;, ORIDA
COUNTY OFy Lx-i COUNTY OF
The forgoing instrugient was acknowl edgeq before me The fpr oing instr ent w s acknowled ed before me
this day of 20 —by this day of 20� by
FOoe� Wl I1a ir" i-
(Name of person acknowledging) (Name of person acknowledging)
i i --m ,- 4(-01
(Signature of Notary'Pubblic- State of Florida) ignature of Mary Public- State of Florida )
Personally Known LI -11 OR Produced Identification Personally Known ��OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. ; t+�e'•., DAWN WVRALD
Commission No.��++�+W
MY COMMISSI0N#GG162348 as���pg9<�. DAWN FITZGERALD
EXPIRES: December 17 2021 MY COMMISSION # GG 16234
F,F;t Bonded Thni Notary Public Undervrriters r. EXPIRES: December 17, 2021
Revised 07/ 15 II "°P oonded Thru Notary Public Underwriters
�_ `FF -
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
BOARD OF MTV PLANNING & DEVELOPMENT
COUNTY SERVICES DEPARTMENT
COMMISSIONERS F L • R I • A Building & Code Regulation
CHECKLIST FOR RESIDENTIAL/COMMERCIAL BUILDING PERMIT
Project Location: 135 PARLIAMENT CT. - RAMSAY
Date:
Permit Number: Technician:
Relluired Documents:
Application completely filled out with Notarized Signatures ............................ Yes VNo N/A
Sub Agreements with Notarized Signatures (prior to issuance) .......................... Yes V 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/AV
Recorded Notice of Commencement (prior to issuance or inspection) ................. Yes No _ N/A_
Utility Agreement or Payment Receipt (prior to issuance).................................Yes No N/AV
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 V
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 V
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
V
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
—No —N/A
CD for Fire Department if commercial or multi -family ...................................
Yes —No
—N/A V
DEP, SFWMD or Army Corp of Engineers (dock, seawall, SF on beach)............
Yes VNo
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
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..........................................................
Yes —No
—N/A
Signed Penetrometer Test (1 copy)......................................................... Y / es 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) ...................................................
Y es
_ No
N A
/
Private Property not in a mobile home park
Class "A" Approval from Planning or file # ................................................ Yes No N/AN
COMMENTS
Revised 10/15/18