HomeMy WebLinkAboutBuilding Permit applicationALL APPLICPBLE�INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: '1� Permit Number:
WMENNOPMEMMW 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 arrow at the end of line
QED
Legal Description:
Property Tax ID #: t -
Site Plan Name- LQ_C)S 2 61 Lot No.—,4i_z_
Block No. Q 7
Project Name:
Setbacks Front_ Back: Right Side: — Left Side:
� ns�a.110�}� o n o� �i Ise.. � r l� �.....:
J
L�NHVAC Gas Tank
CElectric LJ Plumbing
unser this permit- c
[:]Gas Piping
OSprinklers
a
Shutters
Generator
Total Sq. Ft of Construction: SFt of First Floor.
Cost of Construction: $ C) Utilities:'n Sewer Septic
Address:
City: YC
State:
Zip Code:
Fax:
Phone No.- %9C
E -Mail. 1\) f-�-
Fill in fee Simple Title Holder on ne)kt page if different
from the Owner listed above)
0 Windows/Doors
0 Roof = Roof pitch
Building Height:
Name: �J
Company: CS,
Address:
City: State: I 'L
Zip Code: 3Aq -4 It Fax:
Phone No. 23 2, - Lk IV 1 - q, -T I j
E -Mail: I r -k rL i
State or County License:k
K6 --
DU % 0-71 k
If value of construction .1
- IMC16 .#uu or more, a RECORDED Notice Of COMmencernent Is required,
lu" lz';kz'
SUPPLEMENTAL CONSTIhlFORt1AATtC1t1� „3
FRONT
ZONING
SUPERVISOR
PLANS
DESIGNER/ENGINEER:
Not Applicable
MORTGAGE COMPANY:
Not Applicable
Name:
_
Name:
REVIEW
Address:
REVIEW
Address:
DATE
City:
State:
City:
State:
Zip: Phone:
Zip: Phone:
COMPLETE
_
FEE SIMPLE TITLE HOLDER:
Not Applicable
BONDING COMPANY:
Not Applicable
Name:
INITIALS
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 permit will authorize thepermit 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, 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 recoraing your Notice of Commencement. /
S
,Wlature of Owner/Lessee/Contractor as Agent for Owner Si . ure of Contractor/License Holder
STATE OF COUNTYOF FLORIDA F ��
The forgoi g instr meet was acknowledged before me
this yof 20 171–by
{Name of person acknowledging)
L LIL )Li—
(signature
of Notary Public- State of Florida }
Personally Known
Type of Identificai
Commission No.
Revised 07/15/2014
OR Produced Identification
STATE OF E
COUNTY OFORIDASIT UXA
The forgoing instrument was acknowledged before me
this ay of %n , 20 1-1_ by
I IN -MS
(Name of person acknowledging)
0 W o
(Signature of Notary Public- State of Florida )
Personally Known => OR Produced Identification
Type of Identificatior; a- - -�... a........�...
XCOMMIS&RliGG061780 I Commission No.
EXPIRES: January 11, 2021
CHRISTINE CULPEPPER
MY GOMMI,$S"y GG 061780
EXPIRES: January 11, 2021
Bonded Thai Notary Public Undwwam
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
This combination qualifies for a Federal E
Efficiency Tax Credit when placed in sa
between Feb 17, 2009 and flet 31,
Number: 9924469 Date: 312112017
Product: Split System; Heat Pump with Remote Outdoor Unit -Air -Source
Outdoor Unit Model Number: 4TWR5042H1
Indoor Unit Model Number: TEM6AOC42H41+TOR
Manufacturer: TRANE
Trade/Brand name: TRANS
Series name: XR15
Manufacturer responsible for the rating of this system combination is TRANS
Rated as follows in accordance with AHRI Standard 2101240-2008 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),
41000
EER Rating (Cooling):
12.50
SEER Rating (Cooling):
15.00
Heating Capacity(Btuh) @ 47 F:
38500,
Region tV HSPF Rating (Heating):
8.75
Heating Capacity(Btuh) @ 17 F:
24800
' Ratings followed by an astedsk (') indicia a voluntary rerateof pra nusly published data, unless ao»ampart ed with a WAS. which indicates an invuloolwy rarate
DISCLAIMER I
AWRI does nut endorse the products) listed on this Certificate and makes no representations, warranties or guarantees as to, and assumes no responsibility for,
the product{s) listen on this Certifkcatft. AHRI etpressty dtWafiM all liability for damages of any Mud arising out W the use or performance of the product(s). or the
unauthorimd alteration of data i sted.an this Certificate. Certified ratings are valid only for models and configurations listed in the
directory at wsane.ahfidir2ctary.oeg.
TERMS AND COp D[TIONS
This Certificate and its contents are proprietary products of AHRI. This Certificate shall only be used for individual. personal and ,,,,
confidential reference purposes. Tha contents of this Certificate may not, in whole or in part, he reproduced; copied; dissaminated;
entered into a computer databases or otherwise utilized. in any form or manner or try any means, except for the user's individual,
persesnal and eanfid,Mial ret--, AIR-ONCITIONING. Fl FATING.
CERT" FACATE VERIFICATION & REFRIGERATION INSTITUM
The information for she model cited on this certificate can he verified at www.ahr'rdirectory.org., click an -V.Ary C-tifsvato:' link _<<, nt,;la•.Eilc i>etrer,.
and enterthe AHRI Certified Reference Humber and the [tate on which the caraifeete was issued,
which }s listed ab—..and the Certificate. No., which Is listed at bottom tight l�,131345959449154"4
X32014 Air-Cojldltloning, Heating, and Refrigeration institute CERTIFICATE NO.. 131 345 9594 4 91 545$4