HomeMy WebLinkAboutBuilding Permit AppAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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
PERMIT APPLICATION FOR:AIUfninum With concrete
PROPOSED IMPROVEMENT LOCATION:
129 NE Naranja Ave Port St Lucie, FL
Property Tax ID #: 3419-530-0202-000-9
Site Plan Name: RIVER PARK UNIT 4 BLK 39 Lot 16
Project Name: Lipp
Residential X
Lot No. 16
Block No. 39
DETAILED DESCRIPTION OF WORK:
Form and pour 12" x 12" concrete footers and install a 51' 6" x 29' 6" aluminum/screen pool enclosure on existing pool deck.
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: $ 25,950.00 Utilities: —Sewer _ Septic Building Height:
Pond
Pitch
OWNER/LESSEE:
CONTRACTOR:
Name Daniel Lipp
Name: Michael J Newman
Address: 129 NE Naranja Ave
Company: Pioneer Screen Co. Inc. II
City: Port St Lucie State:
Zip Code: 34983 Fax:
Phone No. 462-0250
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
If value of construction is 2500 or more, a KtcuKutu Notice or Lommencemem 1a iequueu.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
'SUPPLEMENTAL CONSTRUCTION LIEN LAW
�IN
DESIGNER ENG
ERt /sAss INEER: _Not Applicable
MORTGAGE COMPANY: Not Applicable
Name: oaates
Name:
Address: PO Box 10039
Address:
City: Tampa State: FL
Zip: 33679 Phone 813-857-9955
City:
State'
Zip: Phone:
BONDING COMPANY: Not Applicable
FEE SIMPLE TITLE HOLDER: — 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..
ie
which is nc onflictwith any applicableiHomethat
Owners Asssocing a at Association ruleswill aby bylaws outhorize r and covenantss that mait holder to restrict the borprohibit ch
structure. Please
s
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 yo property. Notice of Commencement must be recor and poste o the jobsite
before the first in tion. If yo irg�end to obtain financing, consult with 1 er, before
or an at rrt y
commencin w r recor 'n ur Notice of Commencement.
Signature o Owner/ Le ee/Co tractor as Agent for Owner
Signat re of4ontractor/is nse Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Saint Lucie
COUNTY OF Saint Lucie
The or ing nstru nt was acknowledged before me
this tday of 20r by
The fr inginstr ent was acknowledgebefore me
thistday of - '( 20 Ay
Michael J Newman
Michael J Newman
Name of person making statement
Personally V
Name of person making statement
Known OR Produced Identification
Personally Known ✓` OR Produced Identification
Type of identification
Type of Identification
Produced i
P oduced ✓�
1�
F.
(Signature of`Notary P'P . - <.S F ' I°`
f/ x? Fu NotaryPublic State of Florida
�r
(Signature of otary PubiF
TrNot�n .ary Public Stab �bfi�ida
COmmIS510n N0. GG221° Fri ci�i wman
GG 221434
c
Commissi0 o. GG221434 FrAla Newman
My Commission
Expires 05/231202.2
v rnyiy`�ssiorf;Q"34
9 u a o ExlEup,res 05/23/21)22
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED I
j
Rev. 8/2/17
BOARD OF PLANNING & DEVELOPMENT
COUNTY SERVICES DEPARTMENT
COMMISSIONERS F L • ABuilding &Code Regulation
CHECKLIST FOR RESIDENTIAL/COMMERCIAL BUILDING PERMIT
Project Location:
' ��-'
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't- zz '
Filled Land Affidavit (prior to issuance) ...................................................
Yes
✓No
N/A
Recorded Warranty Deed, if applicable ......................................................Yes
No
N/A'Z
Recorded Notice of Commencement (prior to issuance or inspection) .................
Yes
G/"No
N/A
Utility Agreement or Payment Receipt (prior to issuance).................................Yes
No
N/A�-
Vegetation Removal Application with copy of survey ..................................... Yes 7,.I 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
ApprovedSite 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............................................................... Y / 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 v
Signed Energy Calculations (1 set original signatures & signed in 2 spots) ........... . Yes —No NIA
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_11X
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 L/
If Haulingfill off site excess of 100 cubic r
( 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 —No —N/A
PoolBarrier Affidavit.......................................................................... Y / es No N A
Ground Sign Landscape Affidavit (signs) ................................................... Yes No _ N/A
Burn Rate for Sign Cabinets................................................................. . Yes —No —N/A 7
RV and Mobile Home Tie -Down OnU2 copies)
Permit Worksheet (Tie -Down Diagram) ................................................... Yes —No —N/A
Manufacture Set -Up and Installation Manual .............................................. Yes —No —N/A
-Manufacture Blocking Documents .............................. I ........................... Yes —No —N/A
✓j
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 L/
Private Property not in a mobile home park X
Class "A" Approval from Planning or file # ................................................ Y / es No N A_
COMMENTS
Revised 10/5/18