HomeMy WebLinkAbout 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 .4982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
N
Address:.
Commercial --. Residential
To Select from dropbox, click arrow at the end of line
T LOCATION:
Legal Description: _ d -K4) -�S, kDy-(-
VA fi
PropertyTax fD #: 13 La—:� ,
Site Plan Name:
�J,«aA� a r--1
Project Name: � l
Setbacks Front Back:
_ Right Side: Lett Side:
DETAILED DESCRIPTION OF WORK:
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rONSTRUCTl.O,N INFORMATION. 1G
itiona wor to be er orme un er t is permit – c
LK\JHVAC Gas Tank E]Gas Piping
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11 Electric Plumbing Sprinklers
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Lot No.
Block No.
Total Sq. Ft of Construction:
Cost of Construction: $ % G1 —
Shutters windows/Doors
Generator Roof
Roof pitch
Sq. Ft, of First Floor: _
Utilities:Sewer Septic
uwNER/LESSEE. . ..
Name 41
Address:
City:Y�v e.�'}' d l
Stater
Zip Code: C5 Fax:
Phone No. -I- a _ 3U I R –� t
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Building Height:
`wiz -4
CONTRACTOR:
Name: t
0
Orn pany: tA \J C-0
Address: . -] M Q. ti aril
City: Yf' 8+-, '
State: f7i-•-
Zip Code: as Fax: 122 F�3� - 1
Phone No, 7 – -21 d st,C)
E-Mail;SC�� IQ
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State or County License: 41 [y 1 -7
1f value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNEiR/ENGINEER: Not Applicable
Name:
Address:
City: State:
Zip: Phane
EEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: ___� Phane:
BONDING C®MPANY:
Name:
Address:
City:
ZIP: Phone:
____Not Applicable
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, perforin 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
commend r recordi Ur Notice of Commencements-
_ Signature of Owner/ Lessee/Agent
STATE OF FLORIDA , i
COUNTY OF ti��' C -i , L,�
The forgoing instrument was acknowledge before me
this .:=-L day of e 20 by
2�) ')
OL & t B,
V-
(Name of person acknowledging)
(Signature of Notary Public- State of Florida )
Personally Known- OR Produced Identification
Type of Identification Produced
Commission No.
Revised 07/15/2014
REVIEWS IFRONT
COUNTER
DATE
COMPLETE
INITIALS
Signature of
STATE OF FLORID
COUNTY OF `' `r4
The forgoing instrument was acknowledged before me
this a day of � �, 20 � by
(Name of person acknowledging) �"
ag ature of Notary Public- State of Florida )
Personally Known 1-�_ OR Produced Identification
Type of identification Produced
-., LIPJ,ARi� BUUCHAR Commission No.
MY GOMMISSI�N #FF125526 •
398.0153 Florldallotaryservice.com
r,07i 39MJ53
ZONING SUPERVISOR PLANS VEGETATION
REVIEW REVIEW REVIEW REVIEW
.(NDA MA 4AbUCHARE)
MY COMMISSION #FF125526
SEA TURTLE I MANGROVE
REVIEW REVIEW
Certificate of Product Ratings
AHRI Certified Reference Number: 9140780 Date: 2/21/2017
Product: Split System: Heat Pump with Remote Outdoor Unit -Air -Source
Outdoor Unit Model Number: 14HPX-042-230-21
Indoor Unit Model Number: CBX25UH-042-230 *
Manufacturer: LENNOX INDUSTRIES, INC.
Trade/Brand name: LENNOX
Series name: MERIT 14HPX SERIES
Manufacturer responsible for the rating of this system combination is LENNOX INDUSTRIES, INC.
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):
42500
EER Rating (Cooling):
12.00
SEER Rating (Cooling):
14.00
Heating Capacity(Btuh) @ 47 F:
45500
Region IV HSPF Rating (Heating):
8.20
Heating Capacity(Btuh) @ 17 F:
28200
* Ratings followed by an asterisk (*) 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) fisted on this Certificate and makes no representations, warranties or guarantees as to, and assumes no responsibility for,
the produii listed on this Certificate. AHRI expressly disclaims all liability for damages
of any kind arising out of the use or performance
unauthorized alteration of data listed on this Certificate. Certified ratings are valid only for models and configurations listed in the
of the product(s), or the
directory at www.ahvidirectory.org.
This Ce AND CONDITIONS
conte
This Certificate and its contents are proprietary products of AHRI. This Certificate shall only be used for individual, personal and
AS "12�
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.
AIR-CONDITIONING, HEATING,
CERTIFICATE VERIFICATION
The information for the model cited on this certificate can be verified at www.ahridirectory.org, click on "Verify Certificate" link
& REFRIGERATION INSTITUTE
and enter the AHRI Certified Reference Number and the date on which the certificate was issued,
we make life better"
which is listed above, and the Certificate No., which is listed at bottom right.
X2014 Air -Conditioning, Heating, and Refrigeration Institute
CERTIFICATE NO..
131321604682426129