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HomeMy WebLinkAboutSUBMITTED PAPERS• OFFICE USE ONLY BP SECTION TOWNSHIP RANGE MAP NO. ZONING k'�)H5 LAND USE (7 �1 LOT CVG % TAZ NO. FLOOD ZONE FIRM MAP # �j 1ST FLR ELV MAX HGT CONST TYPE OCCUP TYPE MAX OCCUP # OF FLRS WATER C SEWER SPRINKLERS STORMWATER LOT OF REC Before 1/1990 LOT OF REC After 1/1990 LOT SPLIT REQUIRED LOT SPLIT APPROVED REPORT CODE o� HABITABLE AREA (RADON) RADON FEE PERMIT FEE LIBRARY IMPACT FEE PUBLIC BLD IMPACT FEE CORRECTION PUBIC CT FEE GENERAL PARKS IMPACT FEE SCHOOL IMPACT FEE ROAD IMPACT FEE CREDIT Y N LAW ENF IMPACT FEE FIRE/EMS IMPACT FEE DRIVEWAY REQUIRED Y N DRIVEWAY FEE ADMINISTRATIVE VARIANCE FEE SPECIFY SUBS REQUIRED MECHANIC ROOF ELECTRIC- GAS PLUMBING 7 NON -CONFORMING LOT OF RECORD FEES MISCELLANEOUS FEES DATE SENT TO ADDRESSING: / REVIEWS FRONT COUNTER ZONING REVIEW SUPERVISOR REVIEW PLANS REVIEW/ VEGETATION REVIEW SEA TURTLE REVIEW MANGROVE REVIEW DATE RECEIVED 1 jI' • DATE COMPLETED INITIALS' 1 ' OFFICE USE ONLY: , 1) r I L' V ' _007DATE FILED: ✓ 63 PLAN REVIEW FEE: RECEIPT NO.PERMIT NUMBER: —I W CONCURRENCY FEE. RECEIPT NO.: CERT. CAP. NO.: ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED PLANNING & DEVELOPMENT SERVICES DEPARTMENT BUILDING & CODE REGULATIONS DIVISION (:� ^ � SCANNEi 2300 Virginia Avenue r1`F.J BY Ft. Pierce, FL 34982-5652 St. Lucie County 772-462-1553 APPLICATION for BUILDING PERMIT CERTIFICATE of CAPACITY/ZONING COMPLIANCE PROJECT INFORMATION 1. LOCATION/SITE ADDRESS:`��lV`�l 2. PROJECT NA t=, ��c� S SITE PLAN`` NAME: 3. PROPERTY TAX ID #: ���� Sod' ��b`— WzS9 4. LEGAL DESCRIPTION (attach extra sheets if necessary): 5. PLAT BOOK 6. PAGE NO, 7. BLOCK NO. 8. LOT NO. 9. PARCEL SIZE (ACRES/SQ FT.): LOT DIMENSIONS: / 10. COMPLETE DESCRIPTION OF CONSTRUCTION PROJECTOR WORK ACTIVITY: A ,C� 7� Ce jQ=$ .. �r r 11. SETBACKS (ACTUAL) FRONT: _X_:� BACK: �Z_ RIGHT SIDE:_ LEFT SIDE:'1�(0 \b 12. TYPE OF CONSTRUCTION (Check all appropriate boxes) [ ] NEW CONSTRUCTION [ ] EXPANSION/ADDITION [ ] INTERIOR RENOVATION [ ] RESIDENTIAL [ ] COMMERCIA4 INDUSTRIAL [ ] OTHER (SPECIFY) O r Ge A( pt, 13. DESCRIPTION OF PROPOSED USE: 14. SQ, FT OF CONSTRUCTION: / `s� �' 15. SF. FT 1st FLOOR: 16. VALUE OF CONSTRUCTION: $ V The value of construction is used to determine the amount of permit fees to be assessed. St. Lucie County reserves the right to question and/or modify the indicated value of construction if it is demonstrated that the submitted figures are not consistent with similar types of construction activities. If the value is $2500 or more, a RECORDED Notice of Commencement must be submitted with this application. SLCCDV Form No.: 001-02 UPDATED 6/25/09 nWNFR INFORMATION NAME: ADDRE CITSL- STATE: PHONE (DAYTIME): (n1A C<TN9 'SSL3 Email: ZIP: IF THE FEE SIMPLE TITLEHOLDER (PROPERTY OWNER) IS DIFFERENT FROM THE OWNER LISTED ABOVE, PLEASE FILL IN NAME AND ADDRESS BELOW. FEE SIMPLE TITLEHOLDER: ADDRESS: CITY: PHONE (DAYTIME): (_) CONTRACTOR INFORMATION ST. of FL REG.CERT #: BUSINESS NAME: QUALIFIERS NAME: _ ADDRESS: CITY: fx4' STATE: ZIP: ST. LUCIE COUNTY CERT #: "( / C/ !ter ►J `� C`.P l-r'y,— l,A'b`y �i r 1094t% H �d p—lc_ -�- 4'04-G ,/ Q c-, 16Vi- STATE: G' ZIP: PHONE (DAYTIME): C�/-_ III O FAX NO. `3 0/ �' �y1.2 Email: ARCHIT/ENGINEER `� _ �' (� O ADDRESS: CITY: S• STATE: �� ' ZIP: PHONE (DAYTIME): BONDING COMPANY: ADDRESS: CITY: STATE: MORTGAGE LENDER: ADDRESS: CITY: STATE: ZIP: ZIP: IMPORTANT NOTICE: When a permit is issued and it is not picked up within 60 days after notification it will be voided and returned to you by mail. CERTIFICATION: This application is hereby made to obtain a permit to do the work and installations as indicated, and to obtain a certificate of capacity, if applicable, for the permitted work. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits may be required for ELECTRICAL, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, AND AIR CONDITIONERS, FENCES, ETC., not otherwise included with this building permit application. St. Lucie County makes no representation that its granting of a permit will authorize the permit holder to build the subject structure which is in conflict with any applicable Homeowner Association rules, bylaws or any covenants that may restrict or prohibit such structure. Please consult with your Homeowner's Association and review your deed for any restrictions which may apply. The following building permit applications are exempt from undergoing a full concurrency review: room additions, accessory structures (all types), swimming pools, fences, walls, signs, screen rooms, utility substations & accessory uses to another non- residential use. NOTICE 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 YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. NOTICE TO APPLICANT: IF IT IS NOT YOUR RIGHT, TITLE, AND INTEREST THAT IS SUBJECT TO ATTACHMENT: AS A CONDITION OF ISSUANCE OF THIS PERMIT, YOU PROMISE IN GOOD FAITH TO DELIVER A COPY OF THE CONSTRUCTION LIEN LAW NOTICE TO THE PERSON WHOSE PROPERTY IS SUBJECT TO ATTACHMENT. OWNER OR CONTRACTOR SIGNATURE STATE OF FLORIDA COUNTY OF The foregoing instrument as acknowledged befor me this day of 20 by who is personally known vl'or has produced CONTRACTOR SIGNATURE STATE OF FLORID COUNTY OF C/' The foregoing instrument was acknowledged before me this day of `` )W,411 - . 20 , who is personally known or has produced as id tiff ahas id tifi tion. 50YO /i Si of Voiary _ O • Ems Si otary IAN 52 .2015 — OWN i X .(� Commission No. tJ / (Sol) Commission No. �1 Sall E xpirell • •.. PUBLIC JAN 25.2015 • ...... • Q'•; No. EE 58549 NOTARY /// q%OF V,C\\ PUBLIC ` NOTE: TWO (2) SIGNATURES ARE REQUIUR"AACH SIGNATURE MUST BE NOTARIZE II'i/ Pi'f, ''OR THIS BUILDING PERMIT AS AN OWNER/BUILDER, THE OWNER MUST PERSONALLY/SIGN THIS APPLICATION IN THE OFFICE LISTED ON THE FRONT OF THIS APPLICATION. OWNER BUILDER AFFIDAVIT WILL BE REQUIRED FOR ALL OWNER/BUILDER APPLICANTS. For specific instructions see appropriate permit checklist. JOSEPH E. SMITH, CLERK THE CIRCUIT COURT - SAINT LUCIE COC FILE M 3932202 OR BOOK 3610 PAGE 1497, Recorded 03/07/2014 .0:31 AM pill MlT NUMd[R_ ` NOTICE OF COMMENCEMENT The undc,*s,gncd hereby g—A notice that tMPIOvcment will be made 10 certain real property, and - acco'dancc w,d, Chap.c, 713, Flonda statutes the rollaw,ng -forrssst,on is prodded to the Notice of commencement t OESCSUJ'T1nN Of PROPERTY (Legal desert lP' on and street address) TAX FOLIO NUMBER 3.4_19 - S 0 1 - 1 7 0 1 -000 9 f�B S pa n 1 s h,BLOCK TRACT LOT BLDG UNIT_ SUBDMSION �.,�.5_ 1` v ne 4OF Section .26, TQi+nshio 365 me 2 GENERAL DESCR7PTIONOFIMPROVEMENT: Replacement of Mobile Ho�-- 3 OWNER PIFORMATION_ a Name b Address 8000 S- US1, Su1Ce 402, PSL, FL 34952 c ,nierelil-n Pr0lyeay d Name and address of fee simple bt)eholder (,f other than owoer)_,_. 4 C0N7'RAfI'f1R'S NAME. ADDRESS AND PHONE NUMBER \.j'4=A6 X'< vv `-�-4`•-'c!�-�t�-`n t�J``3�o 5. SURETY'S NAME, ADDRESS AND PHONE NUMBER AND BOND AMOUNT: 6 LENDER'S NAME, ADDRESS AND PHONE NUMBER: 7 Persons w.th,n the State of Flonda designated by Owner upon whom notices or other documents may be serveo as p-ovtdut by Sectmn 713 13 (1)(a) 7 Flonda Statums 201 -841 8 NAME, ADDRESS AND PHONE NUMBER. Doug Brantley 1 Silver Oak Or. PSL, FL. 8 In addt1-0,1 to himself Or herself, Owner designates the following to receive a copy of the Ltcnor's NaUCC as prov,UtU a Seud+ 713 13 (1)(b). Flonda Stalules NAME. ADDRESS AND vNONE NUMBER: 9 Eapvaoon date of nonce of commencement (the eaptraoon date is 1 year from the date of recording unless a d-ffe-eel (1a14 's spca Ged) '20- f� Matthew Lyle Wynne V>.c eC_e-&J-dent $tgu lure of ncr or Print Name and Provide Slgnalni y's'i -UdOfllcc O,.ner's A„thotit<d Off"cer/D. It ctorfPartner1Maa age, State of Flonda county of _SS - i t t r l e 011 The foregoing �ast,umenr was acknowledged before me this _day of aCu y 20 B Matthew Lyle Wvnne as VI REsiDE7JT y (Name of person) (Type of aolhonty e g Owner, officer "'1 auor�,cy For Wynne Building Corporation / (Namc of pany on behalf of whom to Str.mcnt was eaecuted) Personally Known '✓ or produced l c 11 w� DOROTHY ANN BASKIN Nobly Public - Stale of /1s,Ms My Comm. ExPkes Oct 2. 2011 RomIY NN �RSKf.J aw.6 ( ` - c anti" l tP 1P 911116 ' (Panted Name of Notuy Public) (S,gnaw re o wary Public) Under penalties of perjury. I decI a that I have read the fore Ong and that the facts to it we 17e 1. u,c best of any c•�o,•leogc ago belief (sectroa n 92 525. Floda ores) Sign elf Owners) or Owner )' A ho,,zed Off cerfDireclor/Pa rtner/Manage who s'gned abovc y By a.. ausaaad tta.,a�n.,p E,TATE OF FLORlok 1iVF`fTIAhT THISISA ,� DV a✓'�p`� ., il�tt .�sLff 5..� •y. � t Grlt�rill fH M �11� .x• ;�s�ii� Lb�sn� Planning & Development Services Building & Code Regulation Division 2300 Virginia Avenue Fort Pierce, FL. 34982 Phone:(772)462-2172 Fax:(772)462-6443 PROPERTY INFORMATION Address: 8 Alhambra South City / State / Zip: Port St Lucie, FI 34952 Parcel #: 3414-501-1701-000/9 Zoning: RMH-5 APPLICATION INFORMATION Permit Number: 1403-0086 Permit Type: MOBILE HOME CONTRACTOR INFORMATION REVIEW COMMENTS Page 1 Owner(s): Wynne Building Corp Jurisdiction: SAINT LUCIE COUNTY Contractor Name: Lisa C Fasnacht Business Name: Lisa's Mobile Home Movers & Installers Inc Business Addr: 1500 Mariner Bay Blvd City / State / Zip: Fort Pierce, FI 34949 REVIEWS AND COMMENTS Review Type Status Reviewed By DOCUMENTS MISSING PENDING Dawn Milone 3/7/2014 Comment: NOTICE OF COMMENCEMENT FRONT COUNTER REVIEW COMPLETE Dawn Milone Comment: Lot#: Block: 1 Stories: Automatic Sprinkler System? No Fax Number: 772-801-5412 Email: Getoutsideanddosomething @Gmail.Com Date Started Date Completed Date Released 3/7/2014 3/7/2014 3/7/2014 PLANS EXAMINER REVIEW INCOMPLETE Ed Roseberry 3/20/2014 3/20/2014 Comment: PLEASE INCLUDE LETTER CERTIFYING EXISTING A/C -HEATING UNIT IS TO BE RE -INSTALLED IN MOBILE HOME, OR SUBMIT MANUAL J ENERGY CALCULATIONS FOR NEW UNIT PER 3280.506(A). ZONING REVIEW COMPLETE Lydia Galbraith 3/10/2014 3/10/2014 3/10/2014 Comment: I?ESIDENTIALICOIV MERCIA L BUILDING PERMIT CHECKLI,S'T Site Location: Q .. _ _ .._ _ PermitNumber: � -�--- � Technician: _._ General: Application completely filled out with notarized signatures Sub Summary List with contractors' names and county & state certification numbers Sub Agreements with original signatures Owner Builder Affidavit Owner Builder Electric Affidavit Filled Land Affidavit Geo or recorded warranty deed Recorded Notice of Commencement Utility Agreement or Payment Receipt Vegetation Removal Permit Non Conforming Lot of Record y i E- f_1 all No N/A Yes r.7 No T7 N/A Yes � No � /N/A Yes No /A Ves No N/A Yes No N/A C Yes o N/A Z/t 0 Yes o / N/A Yes No N/A Yes r.7 No �( /A F., Yes 17 No N/A Plans, Calculations c& Attachments Q copies commercia1/2 residential): Complete set of plans with engineer/architect raised seal Cj Yes Cli Truss plans reviewed and approved by engineer/architect Yes Yes Landscaping and parking plan r 3 Copies of approved site plans 2 Sealed surveys or plot plans with dimensions, finished floor elevation and setbacks Health Department approval stamped on survey and floor plan Health Department food establishment permit stamp on floor plan Manual J or Manual N calculations -Signed Energy Calculations Sealed Wind Load Compliance Certification Product Review Affidavit Page 1 of 2 es Yes r r Yes C Yes C C Yes C E. Yes El f.7 Yes F. Yes F, Noel/i N/A No - /N/A No N/A No N/A No N/A No /A No /N/A No N/A No N/A No N/A No N/A -ESIDENTIAL/COMMERCIA L BUILDING PERMIT CHECKLIST Site Location: Permit Dumber: -- --- ----- —� Other: Health Department permit paperwork CD for Fire Department if commercial or multi -family DEP, SFWMD or Army Corp of Engineers Pool Barrier Affidavit Ground sign landscape affidavit Burn rate for sign cabinets R V and Mobile Home Tie Down Only (2 copies): Permit Worksheet (Tie -down diagram) Manufacturer set-up and installation manual Manufacturer blocking diagrams Signed penetrometer test (1 copy) Stair details Mobile home inspection report for relocation Copy of Title for relocation Class A approval from Growth Management Comments: f_, Signature: �aa�s Technician: — - Clear Form Page 2 of 2 C Yes E- No N/A Yes' NoY.I., N/A r Yes r No N/A r Yes r.7 No N/A Yes C. No N/A es r No N/A Yes No N/A Yes No N/A Yes No N/A r n Yes No N/A Yes No N/A Yes U No 0 /A ED Yes No f� N/A G Yes G No N/A Date: W'. v4AE BUILDING CORPORim ON 8000 South U.S. #1 Suite 402 Port St. Lucie, FL 34952 Spanish Lakes Communities Division Port Saint Lucie March 10, 2014 To: St. Lucie County Building Dept. Attn: Plan Review Re: 8 Alhambra South — Permit # 1403-0086 To Whom It May Concern: Miami Division Miami RC CEIV S MAR2120% PERMiTT'NG St. Lucie County, FL In regards to the abovementioned permit, the air conditioning unit will be moved along with the mobile home. If you have any questions I can be reached at (772) 878-5513. Thank you, Cheri Lynn Adams Permit Administrator FILE COPY Telephones: Port Saint Lucie (772) 878-5513 Miami (305) 235-3175 PLANNING & DEVELOPMENT SERVICES DIVISION BUILDING &CODE REGULATIONS DIVISION 2300 Virginia Ave • Fort Pierce, FL 34982 Y BUILDING PERMIT SUB -CONTRACTOR SUMMARY 01 will be using the following sub -contractors for the (Company ndividual Name) project located at (Street address or Property Tax ID #) change of status regarding the participation of any of the sub -contractors It is understood that if there is any g artment of St. Lucie County. listed below, I will immediately advise the Building and Zoning De p Trade Electrical Plumbing l VAC/ Mechanical Roofing Gas Name of Company/Contractor .� j. ro J St. Lucie County/ State of Florida License Number t 4e v,,� e,' �' g OFFICE USE ONLY: ISSUE DATE: PERMIT ���•— NUMBER: P NNING & DEVELOPMENT Sr AVICES Building & Code Compliance Division BUILDING PERMIT SUB -CONTRACTOR AGREEMENT St. Lucie County Contractor Certification Number: oZ0 'fff State of Florida Certification Number (If applicable): `� __�2, have agreed to be the (Company Name/Individual Name) sub -contractor for (Type of Trade) (Primary Contractor) for the project located at Address or Property Wk M #) It is understood that, if there is any change of status regarding our participation with the above mentioned project, I will immediately advise the Building and Zoning Department of St. Lucie County by filing a Change of Sub -contractor notice. (Form: SLCCDV (No. 004-00) BUSINESS QUAX,MER (Name ofthe Individual shown on the Contractor's License) NOTARIZED SIGNATURES ARE RFQUIRED Business Name: Address: City/State/Zip: Phone: 1,—���/— I�S�/ email: Qi.�� �•��'rt-,� A16NATURE PRINT NAME DATE STATE OF FLORIDA, COUNTY OF S-� t THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS . DAY OF _Z22f} R G N , 20 l Y BY W rn CS (A) , C44W WHO IS PERSONALLY KNOWN ✓OR HAS PRODUCED A,S,�DENTWICATI A�� - Z& SIGNATURE O OTARY PUBLIC OFFICE USE ONLY: PE (STAMP) M N ekva v PRINT NA p NN BASKIN :`io�,�. Notary Public • State of Florida e My Comm. Expires Oct 2. 2016 =° Commission # FF 015226 ��''t%,9;;A°�, Bor" Through National Notary Assn. PERMIT # ISSUE DATE PLANNING & DEVELOPMENT SERVICES Building & Code Compliance Division 'COUNTY BUILDING PERMIT SUB -CONTRACTOR AGREEMENT St. Lucie County Contractor Certification Number: State of Florida Certification Number (If applicable): r � have agreed to be the (Company Name/Individual Name) f Sub -contractor (Type of Trade) ary Contractor) For the project located at (Project Street Address or Property Tax ID #) It is understood that, if there is any change of status regarding our participation with the above mentioned project, I will immediately advise the Building and Zoning Department of St. Lucie County by filing a Change of Sub -contractor notice. (Form: SLCCDV (No. 004-00) BUSINESS QUALIFIER (Name of the Individual shown on the Contractor's License) NOTARIZED SIGNATURES ARE REQUIRED Business Name: Address: City/State/Zip: Phone: email: &; -�� — - A_5� 14;;r 0.*4 C- IZ4 SIGNATURE PRINT NAME 196TE STATE OF FLORIDA, COUNTY OF THE FO GOING INSTRUMENT WAS SI ED BEFORE ME THIS � DAY OF 20 BY cs WHO IS PERSONAL KNOWN PRHAS PRO UCED AS IDENTIFICATION. �% B�Y�, lips,' ��" • i�MS IGN OF NO ARY BLIC PRINT NA E OF NOTARY P BLIC � M &,0/ V/,w Ze a4ii NOTMV SLCPDS: 12/16/2013 '��'�till, ppFV0 %%%���` 01/14/2014 10:24 772878765E WYNNE BUILDIN( iRP PAGE 02/02 PERMIT# ISSUE DATE PLANNING & DEVELOPMENT SERVICES Building & Code Compliance Division BUILDING PERMIT SUB -CONTRACTOR AGREEMENT St. Lucie County Contractor Certificatioxn Number: qR R State of Florida Certification Number (if spplicable): CA.00 2 4 3 7 9 Comfort Control of St. Lucie County, Inc. have agreed to be the (Company Name/Individual Name) air conditioning Sub -contractor for Wynne Development Corp. (Type of Trade) \^ (Primary Contractor) For the project located at (Project Street Address or Property Tax ID #) ' It is understood that, if there is any change of status regarding our participation with the above mentioned l project, I will immediately advise the Building and Zoning Department of St. Lucie County by filing a Change of Sub -contractor notice. (]Form: SLCCDV (No. 004-00) I BUSINESS QUALIFIER (Name of th�llndlvidual shown on the Contractor's License) NOTARIZED SIGNATURES ARE R EtIi I; E' )D Business Name: Comfort Control. ,of St. LuCie County, Inc. Address: 1_ City/State/zip'. Port St. Lucie FL. 34983 Phone: 5 _ ca n n email: S A R Barry Z \ PRINT NAME DATE OF DA. COUNTY OF THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS 3kV�DAY OF , l�Y_�_ , 20� BY ^�—Cry r�nrno _ WHO IS PERSONAI.�,Y KNOWN 1�_ OIt HAS UCED r TU OF OTAI PUBLIC p SLCPDS: 12/16/2013 AS IDENTIFICATION. NAME OF NOTA-0 PUBLIC (STANT) R Notary Public State of Florida Jennie KnightMy Commission FF 045851 Expires Gall 5/2017 7. r, �k ••Y ST. LUCIE COUNTY BUILDING & ZONING 2300 VIRGINIA AVENUE FORT PIERCE, FL 34982-5652 772-462-1553 FILLED LANDS AFFIDAVIT 1, the undersigned, am the owner Of the following described property: ����►�CJ«� Part of 3414 501-1701-000/9- Section 26, Township 36s & Range 40E (Tax ID/LegaJ descriptiori/Address) for which I have applied to St. Lucie County for a Final Development Permit. In accepting this Final Development Permit, BP Number 1 acknowledge that as owner of the above described property, and in accordance with Section 7.04.01(D), St. Lucie County Land Development Code, 1 shall be responsible for assuring adequate drainage so that the immediate community WILL NOT be adversely affected. 1 further acknowledge that in granting this permit for the development of this property, St. Lucie County .is neither obliged nor liable to provide for, or maintain in any form, adequate drainage off my pr erty which will not adversely affect the immediate community. 7 Matthew Lyle Wynne Property Owner Name Property Owner Signature Date STATE OF FLORIDA, COUNTY OF St. Lucie ACKNOWLEDGED BEFORE ME THIS - / 4 DAY OF )�R u� �f 201 BYMatthew Lyle Wynne WHO ISPERSONALLY KNOWN TOME ORWHO HAS PRODUCCO SIGNATURE OF NOTARY NOTARY PUBLIC TITLE S IDENTIFICATION. ftN1� BASIN TYPE OR PRINT NAME OF NOTARY (SLAL) COMMISSION NUMBER DOROTHY ANN BASKIN ;' p Notary Public • State of FWWa • My Comm. Expires Oct 2, 2016 P'= Commission # FF 01$226 �''•`� d''�,, Bonded Through National Notary Alin. THFSE PLANS AND ALL PROPOSED WORK ARE SUBJECT TO ANY CORRECTIONS REOLURED BY REL.D INSPECTORS ftT MAY BE NECESSARY IN ONXR TO »i COMPLY WITH ALL APPLICABLE CO ES. fi s� J) Lu ,ONCEALED FASTENERS OR ATTACHMENTS ARE THE RESPONSIBILIi`I OF THE CONTRACTOR OF RECORD ST. LUCIE COUNTY BUILDING DIVISION REVIEWED FOR COjWrE REVIEWED BY DATE • AN D NG PERMIT' MU,S , oC KEPT vt4 Jukj OR y lu y t. PERMIT NUMBER Installer ,Zi 1 S �/iSH// License # home Address of being installed Manufacturer %� `°'' ' 't Length x width S� NOTE It home is a single wide fill out one half of the blocking plan If home Is a triple or quad wide sketch In remainder of home I understand Lateral Arm Systems cannot be used on any home (new or used where the sidewali ties exceed 5 ft 4 in, Installer's initials Tvninal nicer snaninn -_ PERMIT WORKSHEET I page 1 of 2 New Home ❑ Used Home Home installed to the Manufacturer's Installation Manual ❑ Home is installed in accordance with Rule 15-0 ❑ Single wide ❑ Wind Zone II Wind Zone III ❑ Double wide ❑ Installation Decal # 1-2 Triple/Quad ❑ Serial Not � PIER SPACING TABLE FOR USED HOMES Load bearing capacity Footer sizIze (sq In) 16' x 16' (266) 18 1/2' x 18 1/2' (342) 20' x 20' (400) 22' x 22' ( 484) ' 24' X 24' ( 676) ' 26' x: (676) 100D st 3 1 00 IDSf 4 6 6 8 000 Qst 61 8. 8 2500 pst 7-6-81 B 8 3000 DS1 8 8 3500 s 8 interpowea irom Buie ibu}-i pier spacing taDie. PIER PAD SIZES I-beam pier pad size /% /lX Perimeter pier pad size X .2 Other pier pad sizes (required by the mfg.) ®Draw the approximate locations of marriage wall openings 4 foot or greater. Use this symbol to show the piers. List all marriage wall openings greater than 4 foot and.their pier pad sizes below. Opening Pier padisize !, ,.X 1y71 TIEDOWN COMPONENTS Longitudinal Stabilizing Device (LSD] Manufacturer _ "it H' %' vsrd• Longitudinal Stablll��g Device w/Later 1 Arms Manufacturer ��' ��P^�r e ioy POPULAR PAD SIZES ANCHORS 4 ft 5 ft FRAME TIES within 2' of end of home spaced at 5' 4" oc OTHER TIES Number --- Sidewall Longitudinal Marriage wall She"all PERMIT NUMBER `. ... POCKET PENETROMETER TEST The pocket penetrometer tests are rounde4Adwn to psf or check hereto declare 1000 lb. soil v without testing. X X 1� POCKET PENETROMETER TESTING METHOD 1. Test the perimeter of the home at 6 locations. 2. Take the reading at the depth of the.footer. S. Using 500 lb. increments, take the lowest reading and round down to that increment. X X X TORQUE PROBE TEST The results of the torque probe test is P2— c? b inch pounds or check here if you are declaring 5' anchors without testing . A test showing 275 inch pounds or less will require 5 foot anchors. Note: A state approved lateral arm system is being used and 4 ft. .anchors are allowed at the sidewall locations. i understand 5 ft anchors are required at all centerline tie points where the torque test reading is 275 or less and where the mobile home manufacturer may requires anchors with 4090 lb holding capacity. C'• Installer's initials ALL TESTS MU' ST BE PERFORMED BY A LICENSED INSTALLER Installer Name L/e—J_, n -_pGQ,r_' Date Tested l l/lam Electrical :onnect electrical conductors between multi -wide units, but not to the main power ource. This -includes the bonding wire between mult-wide units. Pg. Plumbing r onnect all sewer drains to an existing sewer tap or septic tank Pg. onnect all potable water supply piping to an existing water meter, water tap, or other (dependent water supply systems. Pg. PERMIT WORKSHEET I page 2 of 2 I Site Preparation Debris and organic material reLwved Water drainage: Natural ✓ Swale Pad Other Fastening multi wide units Floor Type Fastener: 1,4Length: $ Spacing: Walls: Type Fastener 1 4 Length: �T Spacing: Roof: Type Fastener. Length: Spacing: G' ' Forused homes a Min. So gauge, 8" wide, galvanized metal strip will be centered over the peak of the roof and fastened with gals. roofing nails at 2" on center on both sides of the centerline. Gasket (wmtherpmafing requlrenn t) I understand a properly installed gasket is a requirement of all new and used homes and that condensation, mold, meldew and buckled marriage walls are a result of a poorly installed or no gasket being installed. I understand a strip of tape will not serve as a gasket. Installer's initials � Type gasket Installed: f Pg. Between Floors Yes Between Walls Yes Bottom of ridgebeam Yes Weatherproofing The bottomboard will be repaired and/or taped. Yes Pg. Siding on units is installed to manufacturer's specifications. Yes Fireplace chimney Installed so as not to allow intrusion of rain water. Yeses Miscellaneous Skirting to be installed. Yesy No Dryer vent installed outside of skirting. Yes I iWA Range downflow vent installed, outside of skirting. Yes Drain lines supported at 4 foot intervals. Yes Electrical crossovers protected. Yes 1J— Other: Installer verifies all information given with this permit worksheet is accurate and true based on the Installer Signature Date t- St Lucie County Building & Zoning 2300 Virginia Avenue Ft Pierce. FL 34982 Mobile Home Inspection Report All requests for permits to place or replace used Mobile / Manufactured homes must be accompanied by this completed Inspection Report and copies of both sides of the Title to the home. All used Mobile homes must be Wind Zone 11 certif led. Owner: Y�L mr &-D& CORP Date:` /, AV — (Print or type) _ 5 ANt 5H `/LAA-E�s Address: u U D DRT f I C�C C: L. � FAA WIt 7 ,5 M 1 ' q / I (Physical ovation of Home) �/ � tfM8C' 11 O�D7A Year / Manufacturer /9ry I�G/lI�� OF �I Se�faWIIIK 11 S7,3 P076 HUD Plate # - J�5 b �J�O Width / Length 62' Single Double Y Wind Zone . 71: C = In Compliance N = Not in Compliance Fire Safety / Electrical C 1. Smoke Detector: Installed Missing (^,— 2. Electrical System Checked: Exposed Wiring Other C3. Distribution Panel: Missing Loose Main Missing Breaker Missing Unplugged Opening Other G4. Electrical Fixtures: Missing Installed Improperly Improperly Wired Loose Wire GFCI receptacles not where required_ C5. Electrical Ground: Chassis Main Panel Gas Pipe Cop y Rcviwd 1/9/05 Page l of 3 Construction 1. Exit Doors Operable: Front Back Other C 2. Exit Door Locks: Missing Inoperable '_ 3. Egress windows: Missing Inoperable C 4. Windows: Broken Glass Inoperable C- 5. Screens: Missing Damaged C 6. Floor System: Joist Decking Area Damaged C 7. Interior Paneling: Missing Loose Damaged 8. Rodent Proofing: Bottom Board Pipe openings Other 9. Leaks Apparent: Ceiling Doors Floor Roof Ci 10. Vertical tie -down straps: Missing Short Damaged G 11. Structural modifications since manufactured: YES_ NO-V G 12. Walls: Structurally Unsound Loose Weather tight Plumbing C 1. Trap: Missing Not connected Other - C 2. Plumbing fixtures: Missing Not installed Not Vented _C 3. Relief Valve: Missing Inoperable Other 4. Drain Waste and Venting Piping: Missing Not supported Clean outs Use of fittings Not capped Heating and Air Conditioning I. Heating Appliances: Missing Not Connected Other 2. Deleted Heating/AC system: Not installed Other C 3. Thermostat: Missing Inoperable FILE G 4. Air registers: Missing Inoperable C. 5. Ducts: Not sealed Missing Collapsed Page 2 of 3 _ 6. Gas furnace Water heater vent: Missing Loose, 7. Return Air: To Furnace To A/C From rooms _[ 8. Range: Vent Hood 9. Gas Valve: Accessible Installed improperly 10. Gas lines: Not capped Not supported Kinked Not bonded Summary 1. Is subject structure found to be fifty (50%) or more damaged or deteriorated? YES NO�_ 2. Will a remodeling permit be required? YES NO_V---,--, The provisions of the repair and remodeling code shall ensure safe and livable housing and shall not be more stringent than those standards required to be met in the manufacture of mobile homes. Such provisions shall include, but not be limited to, standards for structural adequacy, plumbing, heating, electrical systems, and fire and life safety. FS 320.8232 IF ANY RENOVATIONS OR IMPROVEMENTS OVER AND ABOVE THE REQUIREMENTS OF FS 320.8232 ARE TO BE PERFORMED ON ANY MOBILE HOME WHICH WILL BE PERMITTED TO BE TIED -DOWN IN ST. LUCIE COUNTY, A SEPARATE PERMIT WITH ENGINEERING (IF APPLICABLE) WILL BE REQUIRED. ALL SEPARATE PERMITS MUST OBTAIN A FINAL INSPECTION BEFORE A FINAL INSPECTION IS OBTAINED FOR THE TIE -DOWN PERMIT. NO MOBILE HOME WILL BE ALLOWED TO BE MOVED TO ST. LUCIE COUNTY OR RE- LOCATED WITHIN ST. LUCIE COUNTY UNTIL THE REQUIRED DOCUMENTS HAVE BEEN SUBMITTED, REVIEWED, APPROVED AND THE TIE -DOWN PERMIT HAS BEEN ISSUED. A REGISTERED FLORIDA PROFESSIONAL ENGINEER MUST COMPLETE THIS DOCUMENT, SIGN AND AFFIX Date inspected: / / 1 Q�- Inspected By: �,_„_ Slgn furs required ) Phone Number: ( / �/� � r THEIR SEAL. License # Engineers Seal Page 3 of 3 STEVEN G. WOOD, P-E FL LICENSE 34398 950 SULTAN DR PORT ST LUCIE, FL L11: M- IC3non Numner rear MaKe F—LHMBC115739207A 1996�MERI r kegislered Owner: �— uvr-L-urtr Tssei aegis. rvu. role "umuer56, 72358807 Date of Issue 08/20/2009 ALBERT LEE VELTEMA 1116 HOLLY WALTERS OK 73572 Lien mewase Interest in the described vehicle is hereby released IMPORTANT INFORMATION 1. When ownership of the vehicle described herein is transferred, the seller MUST complete in full the Transfer of Title by Seller section at the bottom of Mail T the certificate of title. 2. Upon sale of this vehicle, the seller must complete ALBERT LEE VELTEMA the notice of sale on the reverse side of this form. 1116 HOLLY 3. Remove your license plate from the vehicle. WALTERS OK 73572 4. See the web address below for more information and the appropriate forms required for the purchaser to title and registerthe vehicle, mobile home orvessel: http:!/www-hsmvstate.fl.us/html/titlinf.html ,,4mmcacwn rvemoer rear maKe -- wi-�-onr ve»�� r�y��. �.�. �FLHMBC1157392070, 1996 MERI f 56' 72358808 i Regisl.ered Owner: Date of Issue 08/20/2009 Lien rceiease ALBERT LEE VELTEMA Interest in the described vehicle is hereby released 1116 HOLLY �y WALTERS OK 73572 I Title IMPORTANT INFORMATION 1. When ownership of the vehicle described herein is transferred, the seller MUST complete in full the Transfer of Title by Seller section at the bottom of Mail To: the certificate of title. 2. Upon sale of this vehicle, the seller must complete ALBERT LEE VELTEMA the notice of sale on the reverse side of this form. 1116 HOLLY 3. Remove your license plate from the vehicle. WALTERS OK 73572 4. See the web address below for more information and the appropriate forms required for the purchaser to title and register the vehicle, mobile home or vessel: htlpalwww.hsmvstate.fl.uslhtml/titlinf.html steps rage i of i Home Specials Appliances Rath Doors $1, Wine ovs E?6r_ctriral Heating N Cooling Home Improvement f4 Rep ahs Kitchen plumbing Set -Up & Transport Fiberglass Code Steps Constructed from pressure -treated lumber j Fiber -glass and resin exterior coating Non-skid surface on all treads and landing Rounded edges and comers White with black "pebble" finish Steps and rails must be purchased separately 38" wide platform on all code steps Part No. Dimensions Side Rail 12-4398C...... 38"W z 14"9 .................12-4399C 12-4412C...... 38"W x 21"H.................12-4411 12-4412C8..... 38"W z 24"H-8" risers ....... 12-44118 12-4413C...... 38-W z 28"H.................12-44114 12-4413CS..... 38"W z 32"H-8" risers ....... 12-441148 12-4415C...... 38-W z 35"H.................12-4416C 12-4415C8..... 38"W z 40"H-S" risers....... 12-44168 12-4417C...... 38"W z 42"H................. 12-4417R 12-4418C...... 38-W z 48"H.................12-441SR Aluninum Code Hack Rail 12-4414....... 38-W Economy Steps and Rails Same construction as our code steps Reduced platform sizes to fit your needs Extruded aluminum rails Steps and rails must be purchased separately Part No. Dimensions Side Rail 12-4398E...... 32"W z 16"9, 14" Platform ..... 12-4399E 12-4390....... 34"W z 16"H, 24" Platform ..... 12-4399 12-44009...... 38"W z 24"H, 14" Platform ..... 12-4406E 12-4402....... 38"W z 24"H, 24" Platform ..... 12-4406 12-4402E...... 38"W z 32"H, 14" Platform ..... 12-4407E 12-4403....... 38"W z 32"H, 24" Platform ..... 12-44064 Special Order Steps Our fiberglass steps can be ordered to fit any application Contact the sales staff for more information Our Company Downloads Tsl_rLnf I�_G4rtlilt>14LtS �4DIASS �!3 A�la2titi�tlrtrica stomer Feedba4k Prima Suooly Home Pr�j�s Site Mao FILE Copy http://atlanticprimesupply.com/id79.htmi 9/6/2008 Apg,O,VED PRODUCTS FOR THE D gOMES �.NSTAEEAT ION OF �N�JFACTURE HOME SAFET' ecPRODUCTS continued MOBILE Ins. Dba Oliver Bax�58/467� p.0. Hohenwald, Tennessee 38462 ON S01LA L M PIER LOADS IN pOL1d 0BASED 0 b. 2,5 1b. NIA) I 1,000 lb. IL s0 oilb• soil soil pad Area soil (ca. ft.) soil ration 20 16" x 16" 16" x 16' 16"x18" 16" x 18 `/:" (rounded) x 18'/z" x 15116„ 1 g 11Z" ,Is 13 '/ " 4„ 7„ x 22„ .-- x 22'/�" (rounded) 17 '/z" x 25 '/z" 24" x 24„ 21.13" x 29•13" (rounded) 1.77 1,79 2.0 2.0 2.360 2.375 2A 2.5 2.75 3.0 3.0 4.0 4.0 4.699 1,770 1,780 2,000 "000 2,360 2,375 2.375 2,500 2,750 3,000 3,000 4,000 4,000 4.699 2,650 2,660 3,000 3,000 3,550 3,563 3,563 3,750 4,125 4,500 4,500 6,000 6,000 7,047 3,450 3,560 4,000 4,000 4,730 4,750 4,750 5,000 5,500 6,000 6,000 8,000 8,000 8.000 3,0001b. Remark soil ' 4,4 4,430 5,000 5,000 5,910 5,599 5,939 6,250 6,875 7,500 7,500 8,000 8,000 pA' oNvIr J� TION9 `_--- pad Area Description tcn. ft.) Pad D mid Footer Co''fs _.-----'�" on toy „ a base and (1) 20" x 20" (2)13 14 x 26 /4 as „ Three (3) 17 x 22 Three (3) 17'/Z" x 25'/7. CAF B®�S .�Y ^ �,TION 1D1E1'�T��-- MOt3EL 0 (-ai) Board 4.9 5.0 6.0 5,310 5,340 6,000 6,000 7,090 5,599 6,400 7,500 8,250 9,000 9,000 8,000 8,000 5,310 5,320 6,000 6,000 7,090 5,600 6,400 7,500 8,250 9,000 9,000 8,000 8,000 1,0001b. 2,000 lb. 3,000 lb. sj soil soil 4,900 9,600 NIA 10,000 N/A 5,000 6,000 12,000 N/A DE5Cj&UON x 16,...-- --- Plastic 2 x� 6„ OT1CB1 --- boards• Plastic Ca Board 90 will, either a single or double stacked cap OTICB2 CMU pier (C ) The cap boards "Jere test on FILL COP 11 � devised 10/10 APPROVED PRODUCTS FOR THE INSTALLATION OF MANUFACTURED HOMES MINUTE MAN ANCHORS, continued... 305 West King Street East Flat Rock, North Carolina 28726 MODEL # IDENTIFICATION DESCRIPTION Soil Class Working Load Ultimate Load MMSPP Longitudinal 20" x 20" x I" Galvanized ALL N/A 26,400 Stabilizing System Steel Base Pad MMLBC Beam Clip for above 3 3/4" x 6" x 7 gauge N/A N/A N/A system MMLBT Brace for above l ''/2" Brace tube (length varies N/A N/A N/A system by pier height) MMA-SD3 Steel Pier Pad 2.75 sq. ft. / 1 I gauge N/A N/A N/A galvanized pad steel beam clips MMA-CAF Concrete Anchor gal. flange for mounting N/A N/A N/A Flange (dry) longitudinal & lateral braces to freshly poured concrete slab MMA-CFW Concrete Anchor gal. flange for mounting NIA N/A N/A Flange (wet) longitudinal & lateral braces to freshly poured concrete MMA-LLBS Kit Lateral Hardware and N/A N/A N/A Longitudinal Struts MMA 14 Concrete Anchors Galvanized concrete (wet) anchor 5/8" dia., Length w/ l - N/A N/A N/A 3/8" turn on end. MMA 42 Concrete Anchors Galvanized concrete (wet) N/A N/A N/A anchor 5/8 dia., 8" length, w/2" hook on end (Revised 04/10) APPROVED PRODUCTS FOR THE INSTALLATION OF MANUFACTURED HOMES MINUTE MAN ANCHORS 305 West King Street East Flat Rock, North Carolina 28726 MODEL # IDENTIFICATION !_�-- --- --- DESCRIPTION Soil Working _.__Load Ultimate Load -----Class--. Galvanized Auger 5/8" x 48" rod, double bolt 4a 3,150 4,725 2' r /IulN6 Anchor head with a single 6" disc _ . Galvanized Auger Anchor MMA 4 3/4" x 48" rod, double bolt head with a single 6" disc 4a 3,150 4,725 MMA 75 Galvanized Auger Anchor '/4" x 60" rod, double bolt head with a single 7" disc 4b 4,000 6,000 MMA 86 Galvanized Auger Anchor '/4" x 60" rod, double bolt head with a single 8" disc 4b 4,000 6,000 MMA 12 Galvanized Concrete Anchor 5/8" x 10" threaded rod with nut. Use with concrete slab Concrete 3,150 4,725 (dry) MMA 14 Galvanized Concrete Anchor 5/8" x 10" rod with a 3" turn on the end. Use with concrete Concrete 3,150 4,725 slab (wet) MMA 42 Galvanized Concrete Anchor Swivel head. Use with concrete slab (wet) Concrete 3,150 4,725 MMA 18 Galvanized Tension Device Double head tension device w/bolt hole in bottom of yoke N/A 3,150 4,725 for use with expansion bolt in concrete slab (dry) MMA 22 Galvanized Tension Double head tension device N/A 3,150 4,725 Device adapter MMA SD2 Galvanized Stabilizer 18" wide x 13.5" center x 71/2" N/A 3,150 4,725 Plate on the sides (Revised 04/10) 5 OD/ LJ/ 4C/1CJ 10. D7 GJJJJJJJOJJ I— LONGITUDINAL BRACE DETAIL OliT91DE HOME h'x2-4' CARRWA BOLT 1-tin' 10 2- 39' POR 12* TO le P1E1! 2- W FOR 12 TO 32: PIER 2- 53" FOR 12' TO 40 PI 2- 65' MR 12' TO 44' PIER K'a2-n' CARRIAGE BOLT 503 PIER IAI La�c GRAM CUP CARRIAGE •;;VS LONGMDINAL & LATERAL BRACING SYSTEM DETAIL ASSEMBLY DRAWING P.. Cauad;'P.�. `St; P.sgl�d'RnGiEeee The MI V9 Mon AnW0FII u85 8roolov Sys mm woo losted td 1NIntl tom 1, n. 61u Tos*d 10110J01 RCS. U002 RM 7114104 Rev. 211110 NOTES MAxMUM PIER HEICNT nR' Mo. SIOEWALL HEIGHT 06' MAX. BEAM SPACING 09.5' MA1I ROOF two 16' "M: 1/2' 9OLTS ARE GRACE 3 2NO PIER N FROMUTHE �$MCES, OF THE HOt9 MAr 9E USED TO MAKE ROOM FOR GRACE TUBES. SML -UP UP C)ME PIN ANCHOMAND DOWNS i have been covered. Now the soil's holding capacity and its effect Soil and the soil bearing capac ty on the anchorage of a home will be covered. Florida has some of the poorest soil in the nation and we commonly refer to it as sand. Note: Anchoring mobile/manufactured homes in Florida is governed by Rule 15C-I for all new and used homes. Florida has several overrides and each will be covered. All anchors and tie down components shall be tested and listed and marked with identification. 70 FILE COPY AM= COOL OF 4x9m0amomm"am karc Alt suopphq rAM be nwsftd WS an Ir. I TIE DOWN ENGIN CER"RED TQ A" AWM' J%STU QUAD TH= G-120 "LVAMIZM -0i &#Mft PON kle 15 C ROW#M' dw 4" bA"jod =am lo misbaposifft a9bak 11 UN&M 3" odalka ft ace Siam .TI,2 IL 3. Usift LN16dame' wis or Aams"L. he" 6! 10011K a" ft aam %wd- Ams dip w�DEtsi. V -W WIP !ft the mW fivt compim A#kx Afw %wane i CR=P 1 Ulm Mkimms 40a the :ma >pdca Eli 2 j 17 FILE COPY aoi L3/ cv1U 10. W.7 GJJJJJJ +++ LATERAL BRACE FLEX TUBES FOR CONCRETE - ----- ---------------_-,- -- --- - --- ---------------_.... _--------- ,..------------O Q i _ _ _ LONGITUDINAL BRACE FLEX TUBES FOR OONGREiE TOP VIEW Length Vorles With A91 OOW LATERAL BRACE DETAIL, SLOE v'IFW LAIF-R& CLAMP ASSEMBLY ?jVT ANO WASHER "*r%o SELF F� S� SCRWS INSTALL AFTER HOME IS SET AND ALL OWER o"T ARE TOW UITERAL TU99 FRAME How M 1—/�W 41 TUBE W FOR 99,V M". SPAN FOR 99 5e MAX. SPAN MAX 4W (AWJM FOR BOM W MAL A WNNV Wft W"F- RIBS.) )i°It2 - �- CARRIAGE 6 1 /i2- MLWY WTV WASHER W/ 1 /•%1.-1 /2" CN'tR1ACE BOL? 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