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HomeMy WebLinkAboutBuilding 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 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 Address: I i)b q& J, U'-5 [tw�'�, �,�I — SV ff (%-.Legal Description: • bm' e 0 en5 Property Tax ID #: t" -F —15011 —Goo I " 2tS�'--1 Lot No. �J J Site Plan Name: /(� I`c Pili-e—f (,. !D�O, V. -e_ U Tt-1 p�iT T),er?4al Block No. �t Project Name: l Q)��� m.LI�U�tP� Setbacks Front Back: Right Side: Left Side: Uk _JQ> r ( I V_C' n C 7f �561em "un Vis [iti a wor to a er ormpermit - c ecC a apply: HnVAC 0 Gas Tank ❑Gas Piping _ Shutters a Windows/Doors Electric 0 Plumbing Sprinklers Generator E] Roof Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $� r)c� Utilities: 0 Sewer E]Septic Building Height: Name cell l12DYT Address: c \�'P✓' r City: 0 CI'e State: Zip Code: Cb3 Fax7172 3 'b'b-q l2') Phone No.Fd�zs E-Mail:/+n�5f'YIQiI h AC'' 14�rfa✓1/1�,tik: �e� Fill in fee ple Title Holder on next page ( if different from the Owner listed above) Name: Company: �VC6��VYI4Yl �Ir'CLI-I��tSYIr�L_ Address: 15� ,c�`'. Y City: P�fi 19- (.t.Pf� State:` P Zi Code: 6� Fax7-2Z -3% �-1 Phone No. ! --asi8 -enz - E -Mail: ti r) (-, ekO()bi State or unty License: 1 ,}� r( O- 0 If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. 1 1141_LTt4;Ii; Name: Address: City: Zip: Phone: FEE SIMPLE TITLE HOLDER: Name: Address: City: Zip: Phone: Not Applicable State: _ Not Applicable MORTGAGE COMPANY: Name: Address: City: Zip: Phone: BONDING COMPANY: Name: Address: City: 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 record' your Notice of Commencement. _ Signatu, ner/ Le ee/Agent Signat ontractor/License Holder STAT ORIDA �+ ST OF FLORIDA COUNTY OF �i �—u� COUNTY OF �91 L.vc I E The forgoing instrument was acknowledged before me this -tray of lei; l 20 1 '1 by .fie Ore Q C Y-D-srr" n (Name of person acknowledging) 7r A N2(.(/1L.Q' rV4i r),1_J , C4' (Signature of Notary Public- State of Florida ) The forgoing instrumentwas acknowledged before me this _`day of >7.1 i20 17 _ by (Name of person cknowledging ) � iJC BC C X Clt L ei GC, X (Signature of Notary Public- State of Florida ) Personally Known OR Produced Identification Personally Known / OR Produced Identification Type of Identification Produced Type of Identification Produced Commission No. =009_:�� �S",) Commission No. FF0C9,1aa. 4 Y �a bea1 KRISTINA L L0UDERI0ACi\ j KRISTINA L LOUDERBACK =_• '1 MY COMMISSION #FFr .322;, FAT UUMMIbblUN #FFo05 X22 _;�•.. Q= EXPIRES August 7, 2C 7 ;�dF°' Revised 07/15/2014 •. .. EXPIRES August 7, 2017 (407) 398-0153 FloridallotaryService,cc_� (407) 398-0153 FloridallotaryService.com REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS certificate of Product Ratings AHRI Certified Reference Number: 7984220 Date: 4/6/2017 Product: Split System: Air -Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: GSX140601K* Indoor Unit Model Number: ASPT61 D1 4A* Manufacturer: GOODMAN MANUFACTURING CO., LP. Trade/Brand name: GOODMAN; JANITROL; AMANA DISTINCTIONS; EVERREST; ONE HOUR AIR CONDITIONING AND HEATING; ENERGI AIR; FRANKLIN 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, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, RI, 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 region(s) for which they meet the regional efficiency requirement. Series name: GSX14 Manufacturer responsible for the rating of this system combination is GOODMAN MANUFACTURING CO., LP. 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): 57000 EER Rating (Cooling): 11.70 SEER Rating (Cooling): 14.00 IEER Rating (Cooling): * 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) listed on this Certificate and makes no representations. warranties or guarantees as to, and assumes no responsibility for, the products) listed on 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 listed on this Certificate. Certified ratings are valid only for models and configurations listed in the directory at www.ahridirectory.org. TERMS AND CONDITIONS This Certificate and Its contents are proprietary products of AHRI. This Certificate shall only be used for individual, personal and 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, AM personal and confidential reference. AIR-CONDITIONING, HEATING, CERTIFICATE VERIFICATION & REFRIGERATION INSTITUTE The information for the model cited on this certificate can be verified at www.ahridirectory.org, click on "Verify Certificate" link we make life better - and enter the AHRI Certified Reference Number and the date on which the certificate was issued, which is listed above, and the Certificate No., which is listed at bottom right. CERTIFICATE NO.: 131359546399057317 ©2014 Air -Conditioning, Heating, and Refrigeration Institute