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HomeMy WebLinkAboutBuilding Permit Application All APPLICABL INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED DatPermit Number: i� 02,oaq,� 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 �/ I PERMIT APPLICATION FOR: I, PR�PaSED INPR�tIEMENT LOCATI Address: 9AR &AaA6& Legal Description: d �� i ,�1 �p /�11 Property Tax ID#: 3 q),T. S 010 S-000 C Lot No. Site Plan Name: '' Block No. Project Name: I Setbacks Front Back: Right Side: Left Side: „1 D TAILED DESS; RIPTI®N01=W@RK: � I CON TRUCTI©N I FORMATION: Additional work to Be performed under this permit–check all that appy: Mechanical Gas Tank Gas Piping Shutters Windows Doors —Electric —Plumbing _Sprinklers —Generator I —Roof Total S Ft of Construction:Sq. � Sq. Ft. of First Floor: Cost of Construction: Utilities: —Sewer —Septic Building Height: ®1NN 12 Name C�®NTRA+TOiR: Name /S/ Name: '''{ 15 Address: - ` fZa& A& ompany: C52,,Z City:_ %b, 212 State: Address: Zip Code:3�� � Fax: City: State: Phone No. "`7 121,1 — 719-- !J, g' III Zip Code: II Fax.: E-Mail: Phone No Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State or County License If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SIJiPPLEMENT/�L CONSTR<11C1`I®N LIEN LAW I�NiI=0RMA1'14N�: 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: 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 thepermit 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 ur Notice of Commencement. Sign ure of OwneLes ee/Agent Signature of Contractor/License Holder STATE OF FLORIna STATE OF FLORIDA COUNTY OFCOUNTY OF Theorgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this q day of�� 20 11-to by this day of 20_ by ':�� up'-U' (Name of person acknowledging) (Name of person acknowledging) gn ture of Notary Public-State of Florida) (Signature of Notary Public-State of Florida) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced �L k��'�lo,�3�• I . 3�•� Commission No. (Sea Commission No. (Seal) LASHAHNAINGRAM J0.Y�L �_ lorida r;omm.✓E% ires Dec 20,2018 REVIEWS F �� UN�I�1 issio �PE-RI SO PLANS VEGETATION SEA TURTLE MANGROVE CO Fay°"' wAwrough alioRBi�lQ*Se• REVIEW REVIEW REVIEW REVIEW in u� DATE PON RECEIVED DATE COMPLETED I—ev.7/2014 i NAMI NOTICE OF PRODUCT LINE CERTIFICATION Certification No.: NI009887-R4 Pa2e 1 Date: 05/17/2009 Revision Date: 05/19/2015 Certification Program: Structural Company: Jeld-Wen ' eov Code: J-104-31 The"Notice of Product Line Certification is valid only when Administrator's Seal is applied to the upper left hand portion of this form and a certification label is applied to the product. This certification seal represents product conformity to the applicable specification and that all certification criteria have been satisfied. The products and systems listed below are approved for listing in the Directory of.Certified Products at www.NAMICertification.com. Please review, and advise NAMI immediately if data, as shown requires corrections. i Company: Jeld-Wen Doors 3737 Lakesport Boulevard Klamath Falls,OR 97601 Product Line: Jeld-Wen's Contours/Energy Saver Glazed Wood Edge Steel Entry Doors w/Glazed Sidelites Test Report: NCTL-110-11987-1,NCTL-110-11988-1 & SJW2009,I200 Section 1: General Description of the Products and Systems,under this Certification 1.1 Frame: The frame jambs consist of wood with all corners coped and butted. The head/jamb corners were fastened with three (4) 16 ga 7/16" crown x 2" long staples per corner. The threshold was attached to the side jambs with three (3) 16 ga 7/16" x 2" long wire staples,;and (2) #8 2-1/2" long screws at each end. 1.2 Door Panel/Sidelite Construction: Each door panel was constructed from two (2) face sheets of 24 gauge (0.021" minimum) galvanized steel and an internal expanded polystyrene foam core. 1.3 Sidelite Glazing: The overall insulated glass unit was comprised of two (2) 1/8" sheets of clear tempered glass. National Accreditation&Management Institute,Inc. 4794 George Washington Memorial Highway,Hayes,VA 23072 TEL(804)684-5124 FAX(804)684-5122 I'