HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1J/ ` ���P Permit Number:
i
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
PERMIT APPLICATION FOR: To Select from dropbox, click here
PROPOSED INPROVEMENT--LOCATION.
Address:a S—C Y )e . ' i C-)
Legal Descriptionpoc)
Property Tax ID #: r`
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side:
DETAILED DESCRIPTION OF WORK.
r'1 CCc ,Cure.
Ir
Residential
Lot No.
Block No.
Left Side:
,-5 e . ,/ l Mt
CONSTRUCTION INFORMATION
A clition orkto be nertormed under this permit --deck all apply:
HVAC Gas Tank Gas Piping p 8 Shutters 'Windows/Doors
11 Electric 0 Plumbing Sprinklers Generator g Roof
Total Sq. Ft of Construction: 5 . Ft. of First Floor:
Cost of Construction: $ 11 {9(o( -e'' C)t _ utilities:]SewerESeptic Building Height:
OWNWLESSEE: CONTRACTOR;
Name�'r�(\C`}r`c f'iC` Name: _
Addr ,ice ��� IC ommy: 1� C1 CL �Ui'Yl� t1
okr-
Cit C ��/_ i State, y�
Zip Code Cl/ Fax: _ City o Lei �1'f� .
l �y c� Stater .
Phone No `. 13�— , j r� Zip Code: A(1 a . _J Fax -
E -Mail: Phone No. + w S_ �F))
Fill in fee simple Title Holder on next page ( if different -Mail: r1'fYlEv.(Y'�� ho mi �~
from the Owner listed above) State or County License: t� 9 y`
If value of construction is $2504 or more, a RECORDED N of Commencement is requi d.
ii�'1C�+G.�10
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FEE SIMPLE TITLE BOLDER: Not Applicable BONDING COMPANY: Not 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 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 a first inspection. If you intend to obtain financing, consul e�eF-or�n atiorney before
co anti r� or recor i rg-vQur Notice of Commencem
_ _ s
Signature of Owner/ Lessee/Agent cn � Signature of Contr`�ctor/License Ho der`
STATE OF FLORIDA
COUNTY OFtk!
The forgoing instrLLnlent was acknowledged before
thiskday of ! I1t`hjl 2Q j by2M Ld M
n h oR
(Name f person acknowled ing) Jq4
(Signature of Notary Public- State of Florida }
Personally Known l� OR Produced Identification
Type of Identification Produced
STATE OF FLOR�I7A w :'
COUNTY OF �,
� 6
The fQjgoing instrument was acknowledged before rn
this` day of Gil/ 24/1 by c
v�'�
Dong I r
(Name of rson acknowledging)—
(ignature of tary Public- State of Florida
Personally Known i/ OR Produced identification
Type of Identification Produced
Commission No.FP1_" (Seal) Commission No.,PCJ` (Seal)
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
Certificate of Product Ratings
AHRI Certified Reference Number: 9099726 Date: 5/8/2017
Product: Split System: Heat Pump with Remote Outdoor Unit -Air -Source
Outdoor Unit Model Number: 4TWR5060H1
Indoor Unit Model Number: TEM4AOC6OS51+TDR
Manufacturer: TRANE
Trade/Brand name: TRANS
Series name: XR15
Manufacturer responsible for the rating of this system combination is TRANE
Rated as follows in accordance with AHRI Standard 2101240-2808 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):
55500
EER Rating (Cooling):
12.00
SEER Rating (Cooling):
14.50
Heating Capacity(Btuh) @ 47 F:
53000
Region IV HSPF Rating (Heating):
8.50
Heating Capacity(Btuh) @ 17 F:
36200
" Ratings followed by an asterisk (') indicate a voluntary rerate of previously publishad 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 Q,
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 farm or manner or by any means, except far the user's individual,
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 "Verity Certificate" link ve make life bei rer
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.
02014 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 131387292117564890