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HomeMy WebLinkAboutBuilding Permit Application _R ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED _ DO , Date: Permit Number: I5ll F 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 Residential 1z PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IIVIPROVEMEIT LOCATIC!N_. _ .._ 3 _. . _.,. Address: S 1 -4 �t�J _ --Piekr� �L _q 4q Legal Description: Property Tax ID#: Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: x _ ep lct�e, CI 0 ®o r b Cl \I- CONSTRUCTION'INFORIVIATION �.,_.�. Additionalwor to be nertormed- under this permit–check all t appy: HVAC Gas Tank OGas Piping _Shutters Windows/Doors Electric ❑ Plumbing Sprinklers Generator Roof Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction:$ ® Utilities: Sewer Septic Building Height: ER/LESSEE,"` CONTRACTO►R , Name J cls r llvm I Name: ,TPrS0�l NeISNEZ., Address: JD5-5' 1= t-dAA ( br Ae, -zvo Company:-1YOPIC0.I J_)()0M 14)Q_ City: V ( State: El, Address: 1 I-33 k-tt')q 6+- Zip Code: Fax: City: C'OC o CI— __State: 1=L Phone No.�IIZ `�'oZ70,31 Zip Code: 32-9 Z.Z Faxcn2l 6_31LO (cly 9 E-Mail: Phone No. '3ZL & 3tp IT48 Fill in fee simple Title Holder on next page(if different E-Mail: :0�CQIDWY61rlc_p Vg4neb-COM from the Owner listed above) State or County 'cense: j.2 CiI&—T 00©75 if value of construction is$2500 or more,a RECORDED Notice of Commencement is req e O SUPPLEMENTAL CONSTRUCTIOWILIENIAW INFORMATION DESIGNER/ENGINEER:• _Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: 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 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 lender or an attorney before commencing work or recording our Notice of mencement. S _Signature of Owner/Lessee/Agent Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA k4e,COUNTY OF COUNTY OF rte' The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this day of Not 20/_by this3 day of 20/5 by 1 V (Name of person acknowledging) (Name of person acknowledgin ) gnature of Notary Public-State of Florida) (Signa re of Notary Public-State of Florida) rso a)ly Known I H P nay Known OR Produced Identification FP T e of Identificatio P# tia Type of Identification Produced �'a EXPIRES:September 8,k18 , Commission No. %;;•'ri9�' Bonded Thru4g��blicUndenutew Commission No. r'���1�. COURTNIt%W(ELLECUBANO .d e+ MY COMMISSION#FF 157845 ,•AEXPIRES:September 8,2018 F.1 Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS Florida Building Code Online http://www.floridabuilding.org/pr/pr_app_dtl.aspx?param=wGEVX... 10 .• ,• BCIS Home Log In User Registration Hot Topics Submit Surcharge Stats&Facts Publications FBC Staff BCIS Site Map links Search j Business �rOeSSiOnd�. Product Approval (` s USER:PublicUser >Product or Appticati4..n_Sear�h>!p91L _k!0j List>Application Detail FL#. FL16107-R8 Application Type Revision Code Version 2014 Application Status Approved Comments Archived Product Manufacturer Clopay Building Products Company Address/Phone/Email 8585 Duke Blvd. Mason,OH 45040 (513)770-6062 mwesterfield@clopay.com Authorized Signature Scott Hamilton shamilton@clopay.com Technical Representative Address/Phone/Email Quality Assurance Representative Address/Phone/Email Category Exterior Doors Subcategory Sectional Exterior Door Assemblies Compliance Method Evaluation Report from a Florida Registered Architect or a Licensed Florida Professional Engineer Evaluation Report-Hardcopy Received Florida Engineer or Architect Name who Scott Hamilton developed the Evaluation Report Florida License PE-63286 Quality Assurance Entity Intertek Testing Services NA Inc.-ETL/Warnock Hersey Quality Assurance Contract Expiration Date 12/31/2028 Validated By Gary Pfuehler Validation Checklist-Hardcopy Received Certificate of Independence FL16107 R3 COI Certification of Independence of Validation Entity- Gy Pfuehler.Qdf FL16107 R3 COI Statement on Independence of Evaluation Entity- ScottHarrj ton 120424.pdf Referenced Standard and Year(of Standard) Standard Year ANSI/DASMA 108 2005 ANSI/DASMA 115 2005 ASTM E1886 2005 ASTM E1996 2009 ASTM E330 2002 TAS 201 1994 TAS 202 1994 TAS 203 1994 1 of 11/3/201512:29 PM