HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLIC418LEANFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: lip Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
1300 Virginia Avenue, Fort Pierce FL 34981
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
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Address:
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Property Tax lD#:13Z-1--7C)N OOZB--0on-0 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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I ona war c ere�jer arroeMrler ffils permit - cI c� �� appy.
,HVAC L i Gas Tank ❑Gas Piping _ Shutters ❑ Windows/Doors
Electric ElPlumbing ❑Sprinklers ❑ Generator ❑ Roof ❑ Roof pitch
Total Sq. Ft of Construction: ScFt. of First Floor:
Cost of Construction:$ (i 1100 OO Utilities. nSewer❑Septic Building Height:
Name, QV\Y\ nroC.,K-
Address:'�915() Tv.i1v-� LD- e.' TQY. 4-11Cy
City: F4- ."Wi F"( C -r-* State: f-- 1 -
Zip Code: 2)1-4 Q 1�1 Fax: H A
Phone No. -1-12-' 32_7� - lo 5 b�1
E -Mail: 1.) f:k
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Name: _J_0yV1.P -N F . (,v-Ivv\G,S
Company:G\;LV\CS. XAe0C?6nC k cwck �\(
Address: _3hIi4 t4 Im 14\&IA
City: FIt. ?i P.YC.e_ State:FL
Zip Code: 3t-lol'-4 Lf Fax: -11 7_- Lk W\ - W1 Z.2_
Phone No. 11i7 - LI to 1- 1.1 11
E-Mail:\��aA L O.Q Y 1 Yv\e5 rA c -CD -(x()1 r.rl Y>-%
State or County License: \Z A Tlt-) \R (Yl \
If value of construction is $2500 or more, a RECORDED Notice of 1:ommencement Is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY:
Q Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: X, Not Applicable BONDING COMPANY: XLNot 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 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, 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.
a ure of Owner/Le/�trr actor as Agent for Owner
STATE OF
COUNTYOFORIDA ST- LULI I✓
The forgoing instrument was acknowledged before me
this � day of Pcp r i 1 . 20 0 -by
J PrlIAESE 1 r- GTI Mks
(Name of person acknowledging
gii
(Signature of Notary Pu�bh'c- Statlorida )
Personally Known 2Q OR Produced Identification _
Type of Ide t*fi UrlPr i,,, 14
Commission No. ^�,W�M" fi@ CHRISTINE�PPER
COMMIS�6� 4 GG 081780
11 .- p" EXPIRES: January 11, 2021
Revised 07/15/2014
REVIEWS FRONT
COUNTER
DATE
COMPLETE
INITIALS
Si ure of Contractor/License Holder
STATE OF COUNTY OF FLORIDA 1�U��t7—
The forgoing instrument was acknowledged before me
this7dayof AQri I .20 ELby
IVkfM�S F G�i�L�S
(Name of person
acknowledging )
(Signature of Notary Pleublic- tats�rida )
Personally Known _>LJ OR Produced Identification
Type of Identificatio _ _ -
Zi.CHRI$TIf1E CULPO'P:'1
IIf Commission No. _ MYCOMMI>) WPGG081780
i; EXPIRES: January 11, 2021
. di lSR"� Baded Tluu Nolery RHk Undervnilers
ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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: 8676081 Date: 413/2017
Product: Split System: Air -Cooled Condensing Unit. Coil with Blower
Outdoor Unit Model Number: 4TTR6049J1
Indoor Unit Model Number: TEM"OC48S41+TDR
Manufacturer: TRANE
Trade/Brand name: TRANE
Region: All (AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, HI, ID, IL, IA, 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: XR16
Manufacturer responsible for the rating of this system combination is TRANE
Rated as follows in accordance with AHRI Standard 2101240.2008 for Unitary Air -Conditioning and Air -Source
Heal Pump Equipment and subject to verification of rating accuracy by AHRlwsponsored, independent, third
party testing:
Cooling Capacity (Btuh): 46500
EER Rating (Cooling): 13.50
SEER Rating (Cooling): 16.00
IEER Rating (Cooling):
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DISCLAIMER
-
AHRldoesnotendorseONproduces) ksI on this Certificate and makes an mpresemaWna warranlles or leasameesas to, wM assumes no responsibllty fpr. -
the prWuct(s)listed enthis COrt MW. AHRI ex preachy disclaims all liability for damages of any kind irking out of the use or performance Of the Products). or the _
unauthorized allemtbn of data I II An this Certificate. certified ratings are valid only for models and configurations listed in the
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alrectory at www.atirlditectory.org.
TERMS AND C
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AISMATIINa,HFATINa,
CERTIFICATE
CERTIFICATE VERIFICATION
_
AsR
®eEGRIen1ATIDX INSIRVIE
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02014 Aly -Conditioning, Heating, and Refrigeration institute CERTIFICATE N0.:
131357922761956946 '_