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Home My WebLink AboutPLAN REVIEWST LU,�%UOUNTY mv � '. .I 2300 Virginia Avenue Ft Pierce, FL 34982 CO.DF, COMP 1A A , DIVISION OUMN1111tu BY St. Lucie CO offico (?72) 46?V53 17wx - (772) 462-1148 Application for Private Providerfor ?.Ian* iew I 110sperfloma (A/E Agreemel't, Revised MY I '� th" StLuclo County Code Compliancit �)Ivi:l PFRMIT fi. DATV: STREET ADDRESS: Parcel TO: St..Lucie County Building Daparruncrit z I-1w I have elected to utilize y4ame of $ulw ittegistocad Amhhd�ct/ Enginece) lt<ll�llanlfit)n 1411111111IV) ORM NAME: M 'S�2�%c �6' 4'J%zrSlda1P". ADDRESS! Tr-LEPHONE 0; FAX 6 as apTivata.p.rovtdar as autharNA111215.353,791, Florida 811atutes. 1h..Iveul%.r1Ato agotbiglTrivattorrovider" for: (check all that apiply): PLANS REVIEW: CTION(s):- _Buildfits� _-Alectrioull, __ylumblug, FEE mmz OWNKR., I have elected to use one or mare private providers to provide buildinji todi's Ian review and/or inspection% acrvicos on the building that Is the subject of the encloaod permit application, -IF ziuri,o- Ized by Part 7al, cilapter,168, Florida statutes & s, 55179 1. Florida Statutes, I understand that the local but Iding. I: Icial MKY ]lot review the Plans submitted or perform the requited building Inspections to determine Lawith die applicable codes, exce-ptla the extentspealfled in said law, Instead, plans review andlor Nquliod (-utid I -, InsPeclio"s ShRU be performed by licensed or cerlifled personnel identified In. the, application. The law:ct III!) vs ellnimuln inswance requirements for such personnel, but I understand that I may require more insurance to lit ot.vl * MY'll'itercsis. BY executing this form, I acknowledge that I have made inquiry xegardittig the compotenue, of lilt., lii;Cr:.cd In, certified ptrsorivel and the level of their Insurance and am saUsfied that my interests Are adequately promm I! I agree to Indemnify, defend and hold harmlaaa the local govi;rArrien and 11.: d building official(s) from any and all claims arising rrom my use of these licensed or cortlflud personnel to iwirl'i r buildt".8 uOda insPOetioll services d IdIUS that is the subject ef, lie!,. lased purillit application, I understart andlor plans review. With respect to the but Ulall if I elect to Make any changes to the listed private pwiders or the sue...! *a to be provided by those P ' rivatel proY[ders, the fee sbriplo..owner I shall, within twc*-four (24) hours ',IY 0111118eq, update the notice to reflect such changost. o, FEE SXMPLE OWNERc (P(kINT-NAMFoFFsA81MAVL 6M) kUA I B) I'l - INS M L�3 (AI)DRESS) �OTARV: STATE OF J Lt)YI 0-41, COUNTY OF Thu fb omg instrmen was acknowledged before me thiS42—Aa.�- I)i JkA.e-- By g:�ne EQk-4�; — My commisklon c,:I- -es: Personally Known (.,' Produced 1D_ Type of idcwillwii'�-)- Signaturc,4114?ta7 P�bl State of -n AMDAVIT VOR PLATI: H �-1 i affirm that I am qualified under chapter 468 or 471, Florida Statu:v.% m as authorized by a. 553.79 1, Florida Statutes pursuant to section 10-1.� 2 building that is the subject of the enclosed permit apprication. I I review the plans submitted or perform the required building inspect mrl.q codes, except to the extent specified in said law. Q VER E23 YULIE A—BARRETT MY COMMISSION #FF132752 E)(PIRES September 2B, 2018 hat 111E; l"id building official may not -etermitic compliance with the applicable I have reviewed the constructia. �ns I documents to determine c6roplinric-t; 1' V - ipplicable codes. I have determined that the plans reviewed comply with the applicable codes. I ' li rL.%pongibility �roy coxill.511,1noo with all provisions of the standard I technical codes and other'Vertinent iaws,:, i rdinancus. I provide my seal and .signature as affidavit under oath, that the f0110)king is tfue-Eird Correct to t;w -.,! - of --ny ]Qiowledge arid belief-. (a) The plans I documents were reviewed by myselE am duly auflim �/x-., a purfoTra plan review pursuant to the code and hold the appropriate licenseg or ceitificaieg. (b) I am qualified as a plan examiner under Part XTI of Chapt�lr 46-14, vI, r i a Statutt;,, (c) '.rhe plans comply with the applicable codes, standards, statates ;tif,J 1 1: il ordbiances or regulatory agency requirem.elits. (d) The plans comply to the laws as to egress, Life Safety Codes, nN nitraction kind general arrangement and show ihe structural design. (e) The plans and design conform to the requirements of the technimi cvc: , as to sr.rongth, stresses, strain and stability. (f) To the best ofmy knowledge, the plans and specifications conpiv ve I theapplicable minimum building codes indtho applicable firc-safety standards as determined b� thu i.;; I audiority in accordance with the 'Florida Building Code and chapter 633 Florida Statutes. I affirm, that I am qualified under s. 468 Florida Statutes to provide WN:ry, iri .-etimn scrvices as authorized by 9. 553.791, Florida Statutes pursuant to section 104.3.2 Florida Bitilding i is undo.rsEood that the undersigned hereby accepts the responsibility for performing all of the required inspccimio. - vn�illed in this document. I understand that inspections are required as detailed 11a Section 105 of dic I- Ioi i I. Building Code, the permit card, and as prescribed by the local authority havingjurisdiction. I further agree t� 1:idd -1 Lucie Comity barnaless for such inspections, -and accept responsibility for compliance with all other reqi m-niw i- contained within. Upon completion of the structure, I will provide the Building Official a certification thatt'lemi i.c. ire, electrical, gas, mechanical and plumbing systems have been erected inaccordanec with requirements o! !IW If L: nical enjus. The undersigned cortifies that all work inspected (and approved) will cez-forn, 1. all applicable codes and standards; as well as all related permit documents. In the event of any conflict betwtvii .:-,,I ts and documents, the more restrictive shall*apply. A log shall he maintained of all inspections rnadE' I:Mlli I ! g tbe date of the inspection, the inspection performed using the permit "hard card" terminology and the, dc"l-pla. onaf either approved or disapproved and an inspection report shall be forwardedto the Building Dcpa-.-r- ient within 72-hours of makingthe inspection. Each inspection report shall bear the seal of the Architect )erfbrm1n1-1thciWP0cti0D,al0n9 with his I her signature and the date. Tito permit will expire'unless work -�-XVV ClIced (and receive,,% an approved inspection "colored radon the permit hard card, red print indicates a rem v-m T% pection which satisfies the 180-day requiremane) within I 80-days (60-days for demolition permits) from t1w �ra I... :ate u rib c permit. All subsequent inspections shall be made within 180-day time frame prior to permit exprutkw. L0_1fLSL�S_CT10NSWMLHF pERFORMED SU13SEQIUF-NT TO PERMIT EXPIRATMS; _N0 in �.ZMMD 0 Ns -WILL MIE (PRINTED NAMS OF ArcIrlicel / Engiflft) 4 4_/WLC (DATP I NOTARY' STA.TE(c)i'V_Z�e/LN4- � COUNTY 0 The fo i�! �snient was �ack z polcdged before me this My cl By Pers nally Known J�-' Produced ID T.Ve i Signature of Notary Public -State of .1 A%xr: zgincer) Architeu� ` Rriz*- ieer Seal- Mienever the owner / contractor desires an inspection to be parformed'-1-v wr�') other ihpip the �aova ot Lucie county inspector, a now application form must be submitted and Dppro--d f)-, :,I St Lucie County Building Official or Building Code Supervisor 13EUORE the subject inspection (a) is (arc - I'MV.: -WE'D N3 The St Lucie County Building Department may at any I all times visit t-ir action sitv to ensure compliance The St Lucie County Building P�-irtmcnt may at any/ all times visit t.,,. I - -�,r%SltVlo ensure compliance 121 and /-or for the purpose of spot Mien% to verifying construction act i ompliance with the construction dorumentq / drawing�. Failure to follow standard operating procedures for inspections for,'[ H.u. Pt County may negate any further approvals for you or your firm to perform this type of inspection. In addi,i, a, Jurojilplete or inaccurate Inspection reports may result in failed inspectlons, work stoppage a�u' 1 ti, -ermil expiration. All violators will be referEed to the YL. D,%j!.g! Should you hnvm any quentiona regarding dils procedure, please contact I:,,. S, ' oic (�Qnnly Building Department 0 Building Official or Building Code Supervisor Print Name signatuorc Date