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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date:~Permit Number:_ 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 )(--'-~-- PERMIT APPLICATION FOR:To Select from dropbox,click here \l"'L: Address:.!:{g40 0ClL{bLD~(yj lrClil _ Legal Description:(to at}40 S '1'2..o~'tJW Y4 of SW '/y if Nt ~4 -l~W W FT -l L 1(0 IfC,J (Oe.224\-21q9) Property Tax 10 #:141 tQ ~\"32 -OD 20 -<XX>-<0 Lot No._ Site Plan Name:Block No._ Project Name:_ Setbacks Front _Back:Right Side:Left Side:_ ~~=_~~~~lfl~~~~--------------------------------------- o Windows/DoorsIIRoof Total Sq.Ft of Construction:_ Cost of Construction:$-'5LCO~'--W _ SCfB;of First Floor: Utilities:USewer DSeptic Building Height:_ Name el~\\ Address:~lffi Sa.dV\LOlod n....,tL=..·l ....•..\_ City:\=Or-\-'C\5rerc-e..State:.£l Zip Code:34f16\Fax:_ Phone No.71'1--42F\-(<JC\q ..•...3'---_ E-Mail:_ Fill in fee simple Title Holder on next page (if different from the Owner listed above) Name:~~LU~~_4~~~LU~~~~~- Company:~~<Ole of #Ie.treosure etas-l Address:(.pOI ~"M!d<d-lhIenue. City:F+:"""?>iea-e...State:~ Zip Code:3\fl1&z..Fax:1]'11-%'0 -lfCIlfS- Phone No.'112-LD.o '6>((J){)(p E-Mail:ad VQj)'~~:oermds@ bo\=roaJ\.(~ State or County License~CA~03<:1 lol.o4 If value of construction is $2500 or more,a RECORDED Notice of Commencement is required. ~UPPLEIV1ENTA[GOj\JSTRUCTIONLlEN LAW lNF,GRIV1ATION:'.(.....}. ,.,'/ , 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 Countx makes no representation that is granting a permit will authorize the germ it holder to build the subject structurewhichisinconlictwithanyapplicableHomeOwnersAssociationrules,bylaws or an covenants that may restrict or prohibit suchstructure,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 your Notice of Commencement. ~~<~~jJ/.d~~,I VJt;;VJn~7j}~ta~ '~gr(ature of Owner!Agent!Lessee Signature of Contractor/License Holder STATE OF FLORI~d LC{()'v STATE OF FLORIDA ~•.[lcC;e.;COUNTY OF 1I COUNTY OF \...(}unt The forgoing inst~b;~was aCknowledgJ1jJefore me ~og instrument w"acknowledged before methiA-tK.day of 11 a fIA 20 by thi day ofRbrua~,20Wby (S1l111l1e i T JJIlf'h4.1Jf -i{)r;u/e./T<.))tt r/~~4'/ (Name of person acknowledging)"-(Name of person acknowledging) /'p.g1,~\lIIlII'111 L_L>Y:?r:?:_LAJ_(~',II --.tj!~l\liltll/li. (Signature of Notary ~~~~F§f Fr~~(Signature of Nota?C-Stat~o .~i.!:i<l.l••~-'%~,~a 'l.\)\i·.\Y~~0 "S'l-I'IRE8 •••0-~ Personally Known .:~'Profj~<i~~arication Personally Known o~&~;"~M'entific~\j~~"-.~.,c-nlt __---Type of Identificatiolt c%d 4 i§i:?:~:E Type of Identification Produce11kllifi ~,~~~'6::: .~£•••9:>~~<#!..>r~~=¥-::z ~~.k ~:g:ll.J: ~·-fA ~'~=4..0 ~<::)~'::;.J--.=:':Commission No.~k '.J >,<l-;";}j)Commission No.'~··Y-r.'"(~~Il#"'~~~I:••••••••••«'3~.JI'of '4 ~•...~ '//11111*NOI f'>?-~\\""~<;,*':~f>~~~.........~,:,-~ -"/111 ..'y'OTA'<:::\\'''' Revised 07/15/2014 11/11//1\\\\\\' REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ,' £'--=!!I CERJIEIEO®, www.ahridirectory.org '~, This combination qualifies for a Federal Energy Efficiency Tax Credit when placed in service between Feb 17,2009 and Dec 31,2016. Certificate of Product Ratings AHRI Certified Reference Number:8902224 Date:2/9/2017 Product:Split System:Air-Cooled Condensing Unit,Coil with Blower Outdoor Unit Model Number:TC7B4821 Indoor Unit Model Number:AE60DX21+TXV Manufacturer:CHAMPION BY JOHNSON CONTROLS Trade/Brand name:CHAMPION HEATING AND COOLING Region:All (AK,AL,AR,AZ,CA,CO,CT,DC,DE,FL,GA,HI,10,IL,lA,IN,KS,KY,LA,MA,MD,ME, MI,MN,MO,MS,MT,NC,NO,NE,NH,NJ,NM,NV,NY,OH,OK,OR,PA,RI,SC,SO,TN,TX, UT,VA,VT,WA,WV,WI,WY,U.S.Territories) Region Note:Central air conditioners manufactured prior to January 1,2015,are eligible to be installed in all regions until June 30,2016.Beginning July 1,2016,central air conditioners can only be installed in region(s)for which they meet the regional efficiency requirement. Series name:LX SERIES Manufacturer responsible for the rating of this system combination is CHAMPION BY JOHNSON CONTROLS Rated as follows in accordance with AHRI Standard 210/240-2008 for Unitary Air-Conditioning and Air-Source Heat Pump Equipment and subject to verification of rating accuracy by AHRI-sponsored,independent,third party testing: Cooling Capacity (Btuh): EER Rating (Cooling): SEER Rating (Cooling): lEER Rating (Cooling): 47000 14.00 17.00 •Ratings followed by an asterisk n indicate a voluntary rerate of previously published data,unless accompanied with a WAS,which indicates an involuntary rerate. DISCLAIMER AHRI does not endorse the product(s)listed on this Certificate and makes no representations,warranties or guarantees as to,and assumes no responsibility for, the product(s)listed on this Certificate.AHRI expressly disclaims all liability for damages of any kind arising out of the use or performance of the product(s),or the unauthorized alteration of data listed on this Certificate.Certified ratings are valid only for models and configurations listed in the directory at www.ahridirectory.org. TERMS AND CONDITIONS This Certificate and its contents are proprietary products of AHRI.This Certificate shall only be used for individual,personal and confidential reference purposes.The contents of this Certificate may not,in whole or in part,be reproduced;copied;disseminated; entered into a computer database;or otherwise utilized,in any form or manner or by any means,except for the user's individual, personal and confidential reference. CERTIFICATE VERIFICATION The information for the model cited on this certificate can be verified at www.ahridirectory.org.click on "Verify Certificate"link and enter the AHRI Certified Reference Number and the date on which the certificate was issued, which is listed above,and the Certificate No.,which is listed at bottom right.,------------------------1131311191613243767 AIR-CONDITIONING.HEATING, &REFRIGERATION INSTITUTE we make life better" ©2014 Air-Conditioning,Heating,and Refrigeration Institute CERTIFICATE NO.: