HomeMy WebLinkAboutPLANS REVIEW - INSPECTIONSST LU(CIE �'��i�ITY CODE C®�[1�>1,�1�`�f4:
2300 Virginia Avenue
Ft Pierce, FL 34992
rColu9�lThY' �';��
Office (772) 462-1553
lrttx • (772) 462-1145
Application for F rivate )P!rovider ffoir Mns i8,c; jew / Inspections
(A/E Agreement. Revised July I. _ Ist)"1.
St Lucie County Code Compliance ivis (I •
PBR1v11T #: DATE: 05/04/2018,_
STREET.ADDRESS: 5061 NORTH HWY Al A EORTPIERC€;€L-34949---
Parcel A, 141460100_009999
TO: St. Lucie County Building Department
FL PE# 47520 / SI# 1061
ihave electedtoutilize .MICR E ;�ej;�!,�,i;,ticnNurnbcr)
(Name of state Registered Architect I Engineer)
ce tud In chapta46a, 41l, Ploridn Statutes)
FiRM NAME: M. L. EI�6Ii EERING INC. ----
ADDRESS' 2030 37TH AVE VERO BEACH- FI s296D
TELEPHONE t7•; 7L 72.�P9-1257 FAX €F 1 772-569=4.049
as a private provider as authorized ins, 553.791, Florida Statutes. I hnvc• ,Icrl -,(Ito asu this "Private Provider'' for:
(check all that apply):
PLANS REVIEW: Building, __Electrical, .chznical,,_____,Plumbing-
(AmdavitRequired) l :chani .tl_ Plumbing.
X INSPEC'TION(s): ,Building, Electrical, ,
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Z C)
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FEE SIMPLE OWNER!
I have elected to use one ormoro private providers to provide building uodrs dan review and/or inspections services
on the building that is the subject of the enclosed permit application, •r< 2irert' r ized by Part XII, chapter 468, Florida
Statutes & s. 553.791, Florida Statutes. I understand that the local bui Idini-. r: ieial may not review the plans
submitted or perform the required building inspections to determine nmpl:a x with the applicable codes, except to
the extent specified in said law. Instead, plans review and/or required t•ttd{I r ., inspee!iuns shall be performed by
licensed or certified personnel identified in the application. The law: ct!trn vs ninimurn insurance requirements for
such personnel, but I understand that I may require more insurance to i:: oVt ' my interests. By executing this form, I
acknowledge that I have made inquiry regarding the competence of the liccr:-ed or certified personnel and the level
of their insurance and am satisfied that my interests are adequately pnm:c:c r
I agree to indemnify, defend and hold harmless the local governmen ;ut'1 i :': it building official(s) from any and all
claims arising from my use ofthese licensed or cenifed personnel trt pt:ri't r buili1mg code inspection services
and/or plans review. With respect to the building that is the subject ci'!he : r loscd punuit application, I understand
that if I elect to make any changes to the listed private providers or tl,c �cr -. es to be provided by those private .
providers, the fee, simple.owncr I shall, within twenty-four (24) hours 4w- ny Chang"', update the notice to reflect
such changes. I - /f
o FEE SIMPLE OWNER:
GENE ROSS, BRYN MAWR PROP arFR
SICNATVitr iI.. i ! E SInIpEE i)v7NER)-
(PRMYNAMSOFFF.l:SI PLE OWNER) (
$ /If 772-569-9853___.___
I MEN:)
(DATE) ,
ELLIOTT MERRILL MANAGEMENT 835 20T-H_PL. VERO_SE.AGH—, F; •32969
(AI)DRESS)
1*1
(ADDRES5) 123
NOTARY:
STATE OF
COUNTY (B
The f going ins me t was acknowledged bafere me this IT c:;!). of
W commiski. ' ype fide RRETT
Signature of Notar�`P—Ubric — State of �,-j��'--JULLE-A-BARRE
Personally Known L-*' Produced ID e -ii e�
11 qION #FF 13Z27 P,
MY COMMISSION #FF13275P),
AWIDA TIFPIL�� R EV n FXPIRES September 28. 20181
Ni
I affirm that I am qualified under chapter 468 or 471, Florida Statu;,:..s m :,1 7 3 1 3 Floi a ma service.com
- -
as authorized by a. 553.791, Florida Statutes pursuant to section 10-1.1 2 -rida Building Code with respect to the
building that is the subject of the enclosed permit application. I unifirrmzr--' hat the local building official may not
review the plans submitted or perform the required building inspecimris I I leternline compliance with the applicable
codes, except to the extent specified in said law.
OVER
I have reviewed the construction plans / documents to determine compl inncc
determined that the plans reviewed comply with the applicable codes. I acccl,
c
h the applicable codes. i have
' 11 responsibility for compliance
with all provisions of the standard. / technical codes and other'pertinent iin; >
signature as affidavit under oath, that the fallowing is true. and correct t.i t:ic ::.
i rdinancus. I provide my seal and
of my latowledge and belief
(a) The plans / documents were reviewed by myself. I am duly au1.1 Itn ire•:
the code and hold the appropriate licenses
o perform plan review pursuant to
or certificates.
(b) I am qualified as a plan examiner under Part XII of Chapter 46x, rlu i
a Statutes.
(c) 'Me plans comply with the applicable codes, standards, statute!, and ! i
: it ordhnutces or regulatory agency
requirements,
(d) The plans comply to the laws as to egress, Life Safety Codes, t. iw n`c
rosouction and general arrangement
and show (he structural design.
(e) The plans and design conform to the requirements of the technical cc-r
: s as to srxangth, stresses, strain and
stability,
(f) To the best of my knowledge, the plans and specifications comp:, v
i the applictdile minimum building
codes and the applicable fro -safety standards as determined b) nt:: i t
i I authority in accordance with the
Florida Building Code and chapter 633 Florida Statutes.
RaspeQlions.
I affirm that I am qualified under s. 468 Florida Statutes to provide builtluip. i r; oction sorvices as authorized by
s. 553.791, Florida Statutes pursuant to section 104.3.2 Florida Building Cod- I is mtdcrstood that the undersigned
hereby accepts the responsibility for performing all of the required inspcittmio. , entilied in this document. i
understand that inspections are required as detailed in Section 105 of the I• lot i I. Building Code, the permit card, and
as prescribed by the local authority having jurisdiction. I further agree tt, I:tdt1 -1 Lucie) County harmless for such
inspections, and accept responsibility for compliance with all other reqt i-rnw- t- contained within. Upon completion
of the structure, I will provide (he Building Official a certification that t•+: au i.e. ire, electrical, gas, mechanical and
plumbing systems have been erected in accordance with requirements o! :bn 1t t: nic:d codes_
The undersigned certifies that all work inspected (and approved) will ccuforn- i. all applicable codes and standards;
as well as all related permit documents. In the event of any conflict between :•,, I is anti documents, the more
restrictive shall apply. A log shall be maintained of all inspections made- hid,i I : g the date of the inspection, the
inspection performed using the permit "hard card" terminology and the dt-%ip n. on of either approved or
disapproved and an inspection report shall be forwarded to the Building Dcptu r tent within 72-hours of making the
inspection. Lach inspection report shall bear the seal of the Architect / I np;;n r i terforming the inspection, along
with his / her signature and the date. The permit will expire'unless work -s -l•rt• enced (mid receives an approved
inspection "colored red on the permit hard card, red print indicates a rem o -c( r. pectiou which satisfies the 180-day
requirement") within 180-days (60-days for demolition permits) from ti-t• Asir..: ate al"the permit. All subsequent
inspections shall be made within I80-day time frame prior to permit expratity, 44 INSEECTIOD15t lirlA L BE
o Architect / Engineer:
MICHAEL A LUE
(PRINTED NAME OFArchitect /Enginrer) (SIGNa
In inccrlT
05/04/2018 772-56 -1
(DATP —' (Pi,,,!
2030 37TH AVE., VERO BEACH, FL 32960
(ADDRESS)
Architec•r Itttt:t leer CHRISTINE L JACRa+r+r•
NOTAiRV' Seal: ; MY COMMISSION N FF962316
STATE OF FLORIDA �� EXPIRES February 1B.2020
COIJNTYOF ramuam Sa °"""
�� wrtabea8
The foregoing instrument was ac owledgcd before me this day of
By MICHAELA.LUE Nlycommissionia,irr:.: __O -�g19090
Personally Known _�. Produced 1D a of�-dentiflca�ttll:
SignatureofNota;Public—StateofEl I( L/ j IoL1Ll i?�lckmai)
Whenever the owner / contractor desires an inspection to be performed'•r anw) a other than the above or a St Lucie
County Inspector, a new application form must be submitted and appror t•ti tr; :,i,, St Lucie County Building Official
or Building Code Supervisor 13EFORE the subject inspection (s) is (are i'ICIt R.ME:1)
The St Lucie County Building Department may at any / all times visit t.tt• con; actlott site- to ensure compliance
The St Lucie County Building lartment may at any / all times visit to con sa• to ensure compliance C 27
and / or for the purpose of spa. a„ pections to verifying construction act vu ic:; i in compliance with the
construction documentq / drawings.
Failure to foliose standard operating procedures for inspections for Ni Ev, Pi County may negate any further
approvals for you ur your firm to perform this Hype of inspection. In addi+i-• %9ueornpletc or irlaccuente
Inspection reports may result in tailed inspections, work stoppage trait , a, -ermh eNpiration. All violators
will be referred to the FL. lD l3 N 1R_
Should you have any questions regarding this procedure, please contact [:it- c ' me Conoly Building Department
4 !Building Official! or Building Code Gupervisor
Print Name
�ignakno-c ------ gDalge