HomeMy WebLinkAboutHennesseyANLL APPLIC 8L
Date:
FO MUST BE COMPLETED FOR
!;i\PPM0Q#4TH 0Em ACCEPTED
Permit Number:
Eu,11dingPermit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34.882
Phone: (772) 462-155 Fax: (772) 462-4578 Commerdai Residential
PERMIT APPLICATION FOR. To Select from dro box, click arrow at the end of line,
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Address:
Legal Description.
-
Property Tax ID -Y-3- �.' ,_. - Lot No.
Site Plan acne. dock No. h
Project Warne:
Setbacks Front Backs Bight Side: Left Side:
HVAC
Tank.
Piumbi
kv k
as Piping
Generator
Doors
Roof pitch
Total Sq. Ft of Construction,S . Ft. of First Floor*
Cost of Construction: $ 1 ZS Z C>0 Utilities: [:]Sewer Septic Building ..�. p g Heiht.
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Name car,e. a
a 4 1. • +
Address: -4 AAr.A Ann,.,
Company:1:is
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city.: _j
.• State: ,L� address
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Zip Code:�r4 ■IYUr IY�/ ��x 1 1 City.
it
State: �
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Pone No. 153 + Zi Code � x•002
E -Mail: Phone No,- Fill in fee simple Title Holder on neat page if different E -Mail:
from the owner listed above) State or CountyLicense,*
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required
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DESIGN ERENGINEERi
, Not Applicable MORTGAGE COMPANY:
�'+ �, Not Applicable
_ Name:
lei
Address: ,Address:
City: State: State:
City: t •
'�
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: / Not Applicable
Name: Name:
Address: - - Address:
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City: City:
Zip: Phone: Zip: Phone:
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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 an applicable Home owners Association rules bylaws or and covenants that may re
�' pp � , strict or prohibit such
structure. Please consult with your Hume Owners Association and review your deed for any restrictions which may appy.
In consideration of the granting of this requested permit, I do hereby agree that 1 will, in all respects, perforin 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
commenciniz work or reicordine your Nonce of Commencement.
atu re of owner/Lesse
STATE of FLORIDA
COUNTY OF
Contractor as Agent for Owner
IRM
The forgoing instrument was acknowledged before me
this S2,day of 20 �by
R�4Es r. G
(Name of person acknowledging
(Signature of NotaN Public- State of Florida
Personally Known OR Produced Identification
Type of Identificati pia re - _
►$�••'''..
CHRISIT11NE CM
pPEPI ER
Commission No.U.M.CommlI GG 061780
'•.,�= EXPIRES: January 11, 2021
Revised 07/15/2014
Si
re of Contractor/ License Holder
STATE of FLORIDA
COUNTY OF
On
The forgoing instrument was acknowledged before me
this day cif r_ V -j , 20 b
s
(Name of person acknowledging)
Personally known
Type of Identification
OR Produced Identification
�t..,,...�x
CHRISTINE CULPEPPER
Commission No. 4br : � � MYCOMMI""y GG 061780
Solt¢� EXPIRES: January It, 2021
••
PAA.!.. ftrKW -Mm NoUq Pct U WaMm
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 Energy
Efficiency Tax Credit when placed in service
between Feta 17,2009 and Dec 31,206,
AHRI Certified Reference Numbern 8676079
70 X40 MMUNISM
product: Split System: Aire ogled Condensing Unit Coil vrith Blower
Outdoor Unit Model Number: 4TTR6036JI
Indoor U ntt Model umber: IT EM4AoC42 41 +T R
Manufacturer. TRAIW
Trade/Brand name: TRANE
Region: All (AK, AL,R AZ, CA3 C01, CT,DC, DEFLI GAjr Hit ID, Il,,1 , IN, KS, KY, LA, MAI
s Mid., mo, MS, M!, NCI D$ NE, NH, NJ, NMI NVI NY, , OH7 OKI OR, PAI 11 SCj Di T o Tx�
UT, VA. VTI W , WV, ''# 1, WY, U.S. Territories
1D, ME,
Region Nate: Central air condifloners manufactured prier to January 1, 2015, are eligible to be
installed in all regions unfit ,lune 30, 2016. Beginning ,Juin' 1, 2016, central air conditioners
can only be installed in region(s) for which they meet the re�llonal efficiency requirement
Series name; XR16
Manufacturer responsible for the retina of this system combination is TRADE
Rated as follows
in accordance with AHRI Standard 2101240w2008 for Unitary A rb onditionin and lr Ource
Heat Pump Equipment and subject to verification of ratingaccuracy by AHRIv-sponsored, independent, third
party testing:
cooling capacity Btuh)*.
EER Rating (Cooling):
SEER Rating (Coaling):
1 ER Rating Cooling):
3640
14.00
17.00
.00
Ratings followed by an asterisk (*) indicate a voluntary rerate of previously published data. unless accorripanied with a WAS, Which indicates an involuntanj Lrerate.
DISCLAtliP E
AHRI does not endorse the procLuct(s) listed on this Certificate and makes no representations, Warrantees or guarantees as Incl �r1ii assumes no responsibility proproduct(s),
r t
the product(s) fisted on this Certificate. AHRI expressly disclaims all liability for damages of any bend arising drat of the use car performance of the product$s�, or the
unauthorized alteration of data listed on this Certificate. Certified ratings are valid only tar models and wnhgurations listed in the
directory 2twww-ahrldire ory.org.
TERMS ,AND CONDITIONS
This Certificate and its contents are prtaprietarY prOdocts of AHRI. This Certificate shalt OnlY be used for individual,
n d`id led' r nal noted;
confidential reference puWses. The contents Of this C�and
e�ificate may note in whole or €n part, lav �� copied;
entered Into a computer database; or otherwise utli
':zed, in any form or manner or by any means, except for the user's iridivrtlaat,
personal and confidential reterenm
CERTIFICATE VERIFICATION
The information for the model cited on this certificate can be verified at vv►w.ahradlrecter;+.o�E;', click can `Verify certificate" lire
and enter the AHRI Certified Reference Number and the date on which the certificate was issued,
whl�Qh is listed wave, and the Certificate No., which is listed at hoftom ript. CERTIFICATE Nl
@2014 Ails -Conditioning, Heating, and Refrigeration Institute -