Port Charlotte 743 Residential Dock/Boat Lift Permit · 2020-01-30 · Building Construction...
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(Electrical permit is required for all lifts, lights, outlets and motorized davits, OR Subcontractor form with Electrical Contractor information completed.) Owner ______________________________________ Contractor: ______________________________________ Address:_____________________________________ Address:__________________________________________ City/State/Zip_________________________________ City/State/Zip:_____________________________________ Phone #: __________________ Fax #:_____________ Email: _______________________________________ Email: ___________________________________________ Charlotte County Community Development Department Building Construction Division 18400 Murdock Circle Port Charlotte, FL 33948 Permitting 941.743.1201 Zoning 941.743.1964 Fax 941.764.4907 Permit # __________________ Master # Parcel ID Number____________________________ ________________________________________________________________________________________ Address where work is to be done Description of work Lot__________ Block__________ Sec._________ Twn..__________ Rge.________ Subdiv ___________________ Flood Zone._________ Map Page:__________ Zoning Class:_________ Corner Lot? Y N Inside Lot? Y N Man-made canal? Y - N Name of body of water________________________________________ Setbacks: Left ______ Right____ Distance seaward. MHWL/seawall ____Dock______Width of body of water____ Docks: Concrete_____ Wood_____ Sq. Ft. _______________ Davits: Pile ____ Pad _____Capacity______ Boat Lift Manufacturer___________________________ Style__________________ Capacity______ Electrical for Dock? Y - N (please circle) Phone: ___________________ Fax #: __________________ The undersigned applicant for this permit hereby certifies that he/she has or will, prior to the performance of any work in connection with the authorization granted under this permit, comply with the provisions of the Florida Workman's Compensation Act of Employer's Liability Insurance and Social Security Act, the Florida Child Labor Laws and other safety and labor laws of the State. Violation will invoke severe Penalties. All work, materials, equipment, and design shall meet the minimum standards of the Florida Building Code 2017-6th Edition and the 2014 National Electrical Code. . I certify that I have read the foregoing and the information I established on this affidavit is true to the best of my knowledge: Signature of Contractor or Owner-Builder Date____________ Contractor license # ____________________________ Construction Cost (including labor) $_________________ Include the following required documents: 1. Manufacturer specifications including foundation design and/or engineered design specifications for concrete piles and docks; all concrete to be a minimum 5,000 p.s.i. for salt or brackish waters (one copy). 2. D.E.P. Permit / U.S. Army Corps of Engineers or other required permits if to be built over State or Federal jurisdictional waters (one copy). 3. Photo copy of property survey showing set backs, all maintenance, utility, and right of way easements (one copy). 4. Dock/Boat Lift site plan showing footprint of proposed scope of work, equipment location (two copies). 5 Subcontractor Worksheet (one copy) 6. Notice of Commencement (one recorded copy submitted prior to scheduling the first inspection). 7. Application form (two copies) Note- All subcontractors must have a Charlotte County Certificate of Competency. Permit is void if construction is not started within 180 days or does not receive an approved inspection within 180 days from the date of issuance. An approved inspection will extend this permit for an additional 180 days .Starting work prior to issuance of a permit may result in a penalty up to four times the permit fee. Warning to owner: Your failure to record a Notice of Commencement (NOC) may result in your paying twice for improvements to your property. Electrical Permit # Residential Dock/Boat Lift Permit
Transcript of Port Charlotte 743 Residential Dock/Boat Lift Permit · 2020-01-30 · Building Construction...
(Electrical permit is required for all lifts, lights, outlets and motorized davits, OR Subcontractor form with Electrical Contractor information completed.)
Owner ______________________________________ Contractor: ______________________________________ Address:_____________________________________ Address:__________________________________________ City/State/Zip_________________________________ City/State/Zip:_____________________________________ Phone #: __________________ Fax #:_____________ Email: _______________________________________ Email: ___________________________________________
Charlotte County Community Development Department Building Construction Division
18400 Murdock Circle Port Charlotte, FL 33948
Permitting 941.743.1201 Zoning 941.743.1964 Fax 941.764.4907
Permit # __________________ Master # Parcel ID Number____________________________ ________________________________________________________________________________________
Address where work is to be done
Description of work
Lot__________ Block__________ Sec._________ Twn..__________ Rge.________ Subdiv ___________________ Flood Zone._________ Map Page:__________ Zoning Class:_________ Corner Lot? Y N Inside Lot? Y N
Man-made canal? Y - N Name of body of water________________________________________
Setbacks: Left ______ Right____ Distance seaward. MHWL/seawall ____Dock______Width of body of water____ Docks: Concrete_____ Wood_____ Sq. Ft. _______________ Davits: Pile ____ Pad _____Capacity______
Boat Lift Manufacturer___________________________ Style__________________ Capacity______
Electrical for Dock? Y - N (please circle)
Phone: ___________________ Fax #: __________________
The undersigned applicant for this permit hereby certifies that he/she has or will, prior to the performance of any work in connection with the authorization granted under this permit, comply with the provisions of the Florida Workman's Compensation Act of Employer's Liability Insurance andSocial Security Act, the Florida Child Labor Laws and other safety and labor laws of the State. Violation will invoke severe Penalties. All work, materials,equipment, and design shall meet the minimum standards of the Florida Building Code 2017-6th Edition and the 2014 National Electrical Code. . I certify that I have read the foregoing and the information I established on this affidavit is true to the best of my knowledge:
Signature of Contractor or Owner-Builder Date____________
Contractor license # ____________________________ Construction Cost (including labor) $_________________
Include the following required documents: 1. Manufacturer specifications including foundation design and/or engineered design specifications for concrete piles and docks; all concrete to be a
minimum 5,000 p.s.i. for salt or brackish waters (one copy).
2. D.E.P. Permit / U.S. Army Corps of Engineers or other required permits if to be built over State or Federal jurisdictional waters (one copy).
3. Photo copy of property survey showing set backs, all maintenance, utility, and right of way easements (one copy).
4. Dock/Boat Lift site plan showing footprint of proposed scope of work, equipment location (two copies).
5 Subcontractor Worksheet (one copy)
6. Notice of Commencement (one recorded copy submitted prior to scheduling the first inspection).
7. Application form (two copies) Note- All subcontractors must have a Charlotte County Certificate of Competency. Permit is void if construction is not started within 180 days or
does not receive an approved inspection within 180 days from the date of issuance. An approved inspection will extend this permit for an additional 180 days .Starting work prior to issuance of a permit may result in a penalty up to four times the permit fee.
Warning to owner: Your failure to record a Notice of Commencement (NOC) may result in your paying twice for improvements to your property.
Electrical Permit #
Residential Dock/Boat Lift Permit
Building Construction Division18400 Murdock Circle | Port Charlotte FL 33948
Building Phone: 941.743.1201 | Building Fax: 941.764.4907Zoning Phone: 941.743.1964 | Zoning Fax: 941.743.1598
[email protected] www.CharlotteCountyFL.gov
"To exceed expectations in the delivery of public services"
A recorded Notice Of Commencement is required in the permitting office prior to scheduling the first inspection.
Application Date
Permit Number
2
For Office Use Only
0
CSR
01/2018
OWNER SIGNATURE
State of Florida, County of
Signature of Notary
Notaries Printed Name
Commission Number
The foregoing instrument was acknowledged before me this
day of 20 by
who is personally known to me or who
has produced as identification and
who did/did not take an oath.
CONTRACTOR/AGENT SIGNATURE
Signature of Notary
Notaries Printed Name
Commission Number
The foregoing instrument was acknowledged before me this
day of 20 by
who is personally known to me or who
has produced as identification and
who did/did not take an oath.
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction.The undersigned applicant for this permit does hereby certify that he/she has or will prior to the performance of any work in connection with the authorization granted under this permit comply with the provisions of the Florida Worker's Compensation Act of EmployersLiability Insurance, the Social Security Act, the Florida Child Labor Laws and all other applicable safety and labor laws of the state. Violation will invoke severe penelties.Owners Affidavit: I hereby certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY.IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOU LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.NOTICE: In addition to the requirement of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this County, and there may be additional permits required from other governmental entities such as water management districts, state, or federal agencies.
Name of Fee Simple Titleholder (if not owner)
Street City State Zip Phone No
Bonding Company Name
Application for Construction Permit
Street State Zip
Architect/Engineer Name
Mortgage Lender
Street State Zip
Street State Zip
State of Florida, County of
