HomeMy WebLinkAboutBuilding Permit Application MAR-03-2017 FRI 09;44 AM CENTRAL SCHEDULING FAX No. 32126861/38 `� /� P- 0011004
Date• E3s '� 1TI Permit Number f ��/ ysWin �
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Building permit Application
Planning and Development5ervjces MAR ®3 1011
Building and Code Regulation Dmslon 1�
2300 Virginia Avenue,Fort Pierce FL 34952
Phone:(772)4621553 Fax:(772)462-1578 'Commercial Residential
PERMIT APPLICATION F6R: To Seleot from dropbox,,click.arrow at the end of line
Address:.,Ac'ii9-4 JAYNetk ST.
T
Legal Description: I-A . 'a T jcW 112 a� Ztoy �T
• r, ► � �� �� 11u •- Liss a.S �TP ._.
PropertyTaz lD#: 3 l 3 4 -- G t,o 2 o to •- o lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
76 S
3 on2 worictone oerformed un ert lspermit—cec all appy:
HVAC Gas Tank DG-as Piping _Shutters a Windows/boors
51ectfic 0 Plumbing Sprinklers L�J Generator D Roof
Total Sq.Ft of Construction: p Sq.Ft.of First Floor:
Cost of Construction: Ce 0 Utilities: Sewer L_lSeptic Building Height:
r
Name \ea WA 11 Name: Ko' vvr-•k
Address: 1` W`dA cr_y t4 a i,1 a'C Company Ct M Jq4 rN- t s(�
City: �7\¢r^c_,e_ �—State:_f�L- Addressiolo 1 W%4 r (`v&-e_ Dr. 1E YU,
Zip Code: 3 4 q 41 !C' Fax: City: %r Y SV 1-,)C2 0- _ State:FL-J
Phone No.-{7'7' •4 tap ^ "7�99•,_,,.•_ Zip Code: 3�1�tiU t9 Fax: '11Z• $~i�-�o119t�
F-Mail: Phone No.
Fill in fee simple Title Halder on next page(if different E-Mail: , zON i e.c &C11 157 rn�f •�d r►
from the Owner listed above) State or County license: C RC-1 ti`s%9
if value of construction is$2500 or more,a RECORDFI)Notice of Commencement is required.
MAR-03-2017 FRI 09:45 AM CENTRAL SCHEDULING FAX No. 3212686138 P, 002/004
EM I
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: _Nbt 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 ppermit will authorize the permit holder to build the subject structure
which is in con lict 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 6empt'from undergaing 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 Commencement.
Signature of wner/Agent/
�L ee Signature of Con actor/License Holder
STATE O' FLORIDA ��J Jt� I sTATE OF COUNTY OF
GRID ,)
COUNTYOF C
The forgoing instrut �ent was acknowledged before me The forgoing instrument was acknowledged before me
this 20Aby this '3 day of 20_11 by
1 ,
(Name of person acknowledging) (Name of person acknowledging
(S gnature of Notary Pupiic-Sta e f Ylorida 1 (Signature of Notary Public-State of F n a J
.Personally Known OR Produced Identification Personally Known_�_OR Produced Identification
.Type of Identification Produced Type of identification Produced
+'lVta$stherIne Kong �� - ($eai)
Commissio Commission No
$+�` Coaia>?ssiaa#PFi�33 ,'t`„'•,, ath
,M' DOND90 TRW T
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Revised 07/15/2014 „,�•' xsTrLQlul ANOT�tt MC Rxplres:
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER R . REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
MAR-03-2017 FRI 09:45 AM CENTRAL SCHEDULING FAX No, 3212686138 P- 003/004
woU CERTIFIED
wwvj.ah rid ir"tory.org
Certificate of Product Ratings
AHRI Certified Reference Number: 9139066 Date: 3/3/2017
Product;Split System;Alr-Cooled Condensing Unit,Coll with Blower
Outdoor Unit Model Number: 14ACX-048230-20
Indoor Unit Model Number: CBX25UH-048.230.*
Manufacturer:LENNOX INDUSTRIES,INC.
Trade/6rand name,I.ENNOX
Region:All(AK,AL,AR,AZ,CA,CO,CT,DC,DE,FL,GA, Hl,ID,IL, IA,IN,KS, KY,I-A, MA,MD, ME,
Ml,MN,MO,MS,MT, NC, ND,NE,NH, NJ,NM,NV,NY,OH,OK,OR, PA, Rl,SC,SD,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 reglon(s)for which they meet the regional efficiency requirement.
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SER:Ratty Ci�plfn - - -
IEER Rating(Coofing):
Ratfngs fulloWed by an astorisk(')indicate a voluntary rerate of previouAly publlshgd data,unless accompanied with a WAS,which indicates an involuntary rersts.
DISCLAIMER
AHRI does not endorse the product(s)listed on this Certificate and makes no roprosentations,warrentles or guarantees as to,and assumes no reBponsibfiityfor,
We pfoduct(s)listed an 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 Ilstod on this Certificate.Cdrtilled ratings are valid only for models and configurations listed In the
directory at www.ahrldlrectory.org.
TERMS AND CONDITIONS
This Certificate and Ito contents are proprietary products of AHRL This Certificate shall only be used for Individual,personal and
confidential reference purposes.The Contents at this Certificate may not,In whole or In part,be reproduced;copied;disseminated;
entered Into a computer database;or othorwho utilIzed,In any form or manner or by any means,exceptforthe users individual,
personal and confidential reference. A1R.CONDMONING,HEATING,
CERTIFICATE VERIFICATION ' ' &REKnIaIERATIONINSTITUTE
The information forthe model cited on this Certificate can be verified at www.ohrld(rectory.org,Click on"Verify Certificate"link %ye make life beftul
and entcrthe AHRI Certified Reference Number and the date on which the certificate was Issued,
which Is listed above,and the Certificate No-r which Is listed at bottom right c;.s?4:;.;:: •f;•3;*:•,:-;
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®2014 Air-Condltloning,Heating,and Refrigeration Institute a"G R7'IFICAT `
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