HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLIC I UL NFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date; W� = Permit Number:
-_ D . , Building Permit Application
e�
Planning and elopment Services
Building and Co eRegulation Divis, on
2300 Virginia A nue, Fort Pierce F� 34982
1
Phone: (772) 4 2-1553 Fax: (772) 462-1578 Commercial
Residential
PERMIT APN� ICATION FOR
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Address: Z -Q%
Legal Descriptio
Property Tax ID
Site Plan Name:
Project Name:
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Total Sq. Ft of
Cost of Constr
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City:
Zip Code:
Phone No.a-I -2- -
E -Mail:—.
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from the Owner list
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nk Gas Piping
Gas Ta S
Shutters
Plumbing El - Shh
OSprinklers 0 Generator
iction: --------- 5Ft of First Floor.
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Sewer Ose"ptic
State: eu_
Fax:
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Lot No, -31 --
Block No. _DL_
LZ777
Windows/Doors
Roof = Roof pitch
Building Height:
Name: 0
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CompanV.,
Add r e s s:
city.. State., E -_L
ZIP Code: aq 9
Fax:
Phone No. -7-7 7 11-, 1 a
Holder on neyt page (if different E -Mail: t I
d above) St
State or County License:
is $2500 ar —ore,! a KKORDED Notice Of Commencement Is required.
DESIGNER/ENGINEER: Not Applicable
Name:
Address:
City: State: _
Zip: Phone:
FEE SIMPLE TITLE' HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone -
BONDING COMPANY: XNot Applicable
Name:
Address:
City:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makas no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable glome 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 t Ie 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 buildin 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 TOOWNER: 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 in pection. If you intend to obtain financing, consult with lender or an attorney before
commencing wor or recording your Notice of Commencement.
ature of Owner/ ssee/Contractor s Agent for Owner Si ure of Contractor/License Holder
STATE OF FLORIDASTATE OF FLORIDA
COUNTY OF - LU ` =- COUNTY OF - UU tz�
The for��,QQ,iin,g instrument was acknowledged
this �`r"day
before me
1�bY
of
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CHRISTINE CULPEPPER
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EXPIRES: January 11, 2021
Bonded Thm Notary Pubk Undervnitem
(Name of person ackr owledging }
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(Signature of Notary
ublic- State of Flo
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Personally Known
OR Produced
Identification
Type of Identificat'
REVIEW REVIEW
Produrprl ---
DATE
The forgoing instrument was acknowledged before me
this S�Nay of N CA 20 1-1 by
(Name of person acknowledging)
(Signature of Notary Public- State of Florida y
Personally Known >9 OR Produced Identification
Type of Identification o,-A,.-Qal .., �,.......�.r..
S.'��•. '•,,
Commission No. • -
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Revised 07/15/2044
CHRISTINE
COMENI14
EXPIRE
C EPPERrxt::
GGOBf780
January 11, 2021
Commission No.
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CHRISTINE CULPEPPER
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EXPIRES: January 11, 2021
Bonded Thm Notary Pubk Undervnitem
REVIEWS
FR NT
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COUNTER
ZONING
REVIEW
SUPERVISOR
PLANS VEGETATION
SEA TURTLE MANGROVE
REVIEW
REVIEW REVIEW
REVIEW REVIEW
DATE
COMPLETE
INITIALS
Cortifioate 6f Product Ratings
AH I Certified eferen a Number: 9199271 Bate: 3114/2017
Product: Split System: Ai-Conlyd Condensing Unit, Coil with Blower
Out d or Unit Madel Number: CA16NA036*0* A*
Indo) r Unit Model Number: FX41)N(B,F)037L
Mani facturer: CARRIER IR CONDITIONING
Trad /Brand na e: CARRIER AIR CONDITIONING
Regi 3n, Southeast and North (AL, AR, DC, DE, FL, GA, HI, KY, LA, MD, MS, NC, OK, SC, TN, TX, VA
AK, CO, CT, ID, IL, IA, IN, 5, MA, ME, MI, MN, MO, MT, ND, NE, NH, NJ,
NY, H, OR, PA, RI, SD, L T, VT, WA, WV, WI, WY, U.S. Territories)
i
Regi,,,n Nate; C �,' tral air onditioners manufactured prior to January 1, 2015, are eligible to be
inst led in al] rdgions un it June 30, 20'16. Beginning July 1, 2016, central air conditioners
can my be instilled in r gion(s for which they meet the regional efficiency requirement.
Seri s name: 16:ZEER A
acturer 4reponsible"for the rating of this system combination is CARRIER AIR CONDITIONING
as folioin accor ance with AHRI Standard 2'101240-2008 for Unitary Air -Conditioning and Air -Source
ump Eqwent and subject to verification of rating accuracy by AHRI-sponsored, independent, third
Cooling Capaci (Btuh) 34600
EER R! ting (Coc ling): 12.50
SEER Mating (Cooling): 15.50
IEER Rating (Co ling):
' Ratingidt(s)
owed by an asterisk () indicel a voluntary cerate of previously published data, uniess accompanied with a WAS, which indicates an involuntary rerate.
DISCIER
AHRI itnot endorse the product(s) f .ted on ih, Certificate and makes no representations, warranties or guarantees as to, arid assumes no responsibility for.
the prolisted on this, Certificate. HRl expressly disclaims all fiabffity for damages of any kind arising out of the use or performance of the product(s), or the
unauthd alteration of data listed o this Certificate. Certified ratings are valid only for models and curl fttrations listed in the
TERMS Np CONDITIONS
This Cert Cate and its contents are prol fieWry products of AHRI. This Certificate shall only he used for individual, personal and
confidenat reference purposes. The Co nts of this Certificate may not, in whole or In part, be reproi£uCad; copied; disseminated;
entered 1 ..
computer database; orot erwise utilized, In any form or manner or by any means, except for the user's Individual,
personal Ind confidential reference.
CERTIFI ATE VERIFICATION
The Infor ation for the model Ccted on t s; certificate can be verified at v. v. s.:,bnduocxc.n nrr„ click on ^":,,: link
and ente the AHRI Certified Reference umber and the date on which the certificate was issued,
which Is. ed stove, and the Certiffca[ No., which is listed at bottom right
2201 Air -Conditioning, Heat ng, and Refrigeration Institute CERTIFICATE NO.:
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AIR-CUNoiitoNINh 411 704TG
A RErRI&ERATICN INSTfiU
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