HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
��o l�l"J�llLS
Permit Number:
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:Aluminum With Concrete
PROPOSED IMPROVEMENT LOCATION:
Address: oou4 Santa tiara Blvd Fort Pierce, FL 34951
Property Tax ID #: 1301-611-0339-000-8
Site Plan Name: Lakewood Park Unit 9 BIk 116 lot 12
Project Name: Hilberts
Residential X
Lot No. 12
Block No. 116
DETAILED DESCRIPTION OF WORK:
Form and pour a 22' x 26' concrete slab with 8" x 8" footers and install a 22' x 26' aluminum/screen enclosure with a 1 V x 28' poly roof.
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
Electric _ Plumbing _ Sprinklers Generator
Total Sq. Ft of Construction:
Cost of Construction: $ 17,790.00
Sq. Ft. of First Floor:
Windows/Doors Pond
Roof Pitch
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Chad Hilberts
Name: Michael J Newman
Address: 6504 Santa Clara Blvd
Company: Pioneer Screen Co. Inc. II
City: Fort Pierce State:
Zip Code: 34951 Fax:
Phone No. 559-5860
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
-- -- ��••�-•-• •�•a nr_..%jRUCLJ NULKe of wmmencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAIN INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: Do Kim & Associates
MORTGAGE COMPANY: — Not Applicable
Name:
Address: Po Box 1oo39
Address:
City: Tampa State: FL
Zip: 33679 Phone 813-857-9955
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
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 your paying twice for
A Notice of Commencement must be recorded and post on the jobsite
improvements to your prope�'J
before the first ' 1spection. Ifintend to obtain financing, consult with I der or an a rney before
co ncin k or recorour Notice of Commencement.
Signature Pf Owner/ Vessee4Contractor as Agent for Owner
Signature of C tractor/Uce a Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Saint Lucie
COUNTY OF Salt Lucie
The f„o,r��ing instr m nt was acknowledged before me
this% day of e<r 20,1�by
The forgoi g instru nt was acknowledged before me
this ay of 20 by
Michael J Newman
Michael J Newman
Name of person making statement
Personally Known lv OR Produced Identification
Name of person making statement
Personally Known ,-" OR Produced Identification
Type of Identification
Type f Identification
Produced
Prod ed r
f
f
2
a
(Signs ure of otary P lic- a e•p ; orl a
T'e l e •. FRANCENE NEWMAN
Nota Public State of=lorida
Commissio No6eerohe4 a° "a (S
c: it mission # HH 236446
3 �et.t `••, oF�° My Comm. Expires May 23. 202
l Bonded through National Notary Assn.tt�t
Signature o of Public- at f p..,•
�*w` �� FRANCENE NEW
: eG��a
)Notary Public - State
ommission No �-
[�.(t.— �� Commission # HH 236
�� �� rti. My Comm. Expires May
Bonded through National No
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
j
Rev. 8/2/17
rida
!026
issn.
BOARD OF PLANNING & DEVELOPMENT
COUNTY OUNTY SERVICES DEPARTMENT
COMMISSIONERS FLO R I • - Building & Code Regulation
CHECKLIST FOR RESIDENTIAL/COMMERCIAL BUILDING PERMIT
Proiect Location: U50 Sa A+tA UAY-a � JdDate: 3 110 ZL
Permit Number: Technician:
Required Documents:
Application completely filled out with Notarized Signatures ............................ Yes VNo 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
NIA ,/
Vegetation Removal Application with copy of survey.....................................Yes
V/ No
N/A
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 /
es 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 i%
Health Department Food Establishment Permit stamped on floor plan ................
Yes
—No
—N/A- V
Manual "J" or Manual "N" Calculations....................................................
Yes
No
N/A t/
Signed Energy Calculations (1 set original signatures & signed in 2 spots) ........... .Yes_No
N/A 1%
Sealed Wind Load Compliance Certification ...............................................
Yes
—No
—N/A
Product Review Affidavit.....................................................................
Y
Yes
✓ No
/ A
—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 f
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 V
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 -
PoolBarrier Affidavit.......................................................................... Y / 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 —NIA
Manufacture Set -Up and Installation Manual .............................................
Yes —No —N/A
Manufacture Blocking Documents.......................................................... ..... es No N
.. Y N/A
Yes No N/A `'
Yes No N/A
Yes —No —N/A V
Yes No N/A�
/_
Yes No N/A /
Signed Penetrometer Test (1 copy)
StairDetails......:............................................................................ .
Mobile Home Inspection Report for Relocation (used only) ...........................
Copy of Title for Relocation (used only) ...................................................
Private Property not in a mobile home park
Class "A" Approval from Planning or file # ................................................
COMMENTS
Revised 10/5/18