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HomeMy WebLinkAboutpermit applicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: T Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Fierce FL 34982 Phone. (772) 462-1553 Fax: (772) 462-1578 Commercial Residential r PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line Address: 1_00 UY '�' . CU Pc r, .. V Legal Description: . -QC,, (k)-, Property Tax ID #: Site Plan Name: Project Name: Setbacks Front Back: Right Side: Left Side: Lot No. Block No. J I e. CJIC',r% Cr ©t_- l o k t �vf 1 �' 1� t , I �., t i is A-P,1ci _6X J 1 -+w TM r o2 fib rl t Plumbing Total Sq. Ft of Construction: Cost of Construction: $ ��j" Sprinklers L.,J Shutters LJ Generator SFt, of First F�lojor: _ Utilities:CnSewer L JSeptic Name Address:, City: e;,,Se,..'3�,c_� State: r=L Zip Code: 3LJ Fax: Phone No.,�F(r�- 9y y E -Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) Name: Windows/Doors Roof Building Height: Roof pitch Company: Address % S. �v t City: 6,4-001.,?, TStater Zip Code: s3 q f oL Fax:a=y�o . yet y�57' Phone No. +TD, , clUd'• /Lroi4 E -Mail: State or County License: 3�c nAn- � If value of construction is 12500 or more, a RECORDED Notice of Commencement is requ"rred, DESIGNER/ENGINEER: Name: _ Address: City: Zip: Phone: FEE SIMPLE TITLE HOLDER: Name: Address: City: _ zip: Phone: — Not Applicable State: Not Applicable MORTGAGE COMPANY: Not Applicable Name: Address: City: State: Zip: Phone: BONDING COMPANY: —Not Applicable 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, l 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, wails, signs, screen rooms and accessory uses to another non-residential use WARNING TO OWNER: Yodr 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 our Notice of Commencement. azure of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder S STATE OF FLORIDA'' STATE OF FLORIDA COUNTY OF r COUNTY OF T ae-,v The forgoing instrument was acknowledged before me this /!slay of 2017 by 5C4 i (Name of person acknowledging) ae° (Signature of Notary Public- State of Florida) Personally Known a OR Produc Iderj`� Type of Identification Produced ::� uary;`�v Commission No. LF0 7312 85- ; (Seplj�•o r� � a ?c a 0�425g Revised 07/15 2014 ,71';° F1STATF�Q�-, ` The forgoing instrument was acknowledged before me this /'`'qday of 20 Z by (Name of person acknowledging) of NotarfPublic- State of Flo r% r .) � I " Personally Known /� OR Type of Identification Produce Commission No. E Ee27y �p REVIEWS FRONT ZONING SUPERVISOR PLANS COUNTER REVIEW REVIEW REVIEW DATE COMPLETE INITIALS ae o, ® ern i (51 # � ' 95,9 k VEGETATION I -SEA TURTLE IMANGROVE REVIEW REVIEW REVIEW Certificate of Product Ratings AHRI Certified Reference Number: 8456303 Date: 6/14/2017 Product: Split System: Air -Cooled Condensing Unit, Coll with Blower Outdoor Unit Model Number: TC4132421 Indoor Unit Model Number: AP24BX21+TXV Manufacturer: CHAMPION BY JOHNSON CONTROLS Trade/Brand name: CHAMPION HEATING AND COOLING Region: Southeast and North (AL, AR, DC, DE, EL, GA, HI, KY, LA, MD, MS, NC, OK, SC, TN, TX, VA AK, CO, CT, ID, IL, IA, IN, KS, MA, ME, MI, MN, MO, MT, ND, NE, NH, NJ, NY, OH, OR, PA, RI, SD, UT, VT, WA, WV, Wl, 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: LX SERIES Manufacturer responsible for the rating of this system combination is CHAMPION BY JOHNSON CONTROLS 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): 23200 EER Rating (Cooling): 11.50 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 product(s) listed on this Certificate. AH RI 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 CONDITIONSAss ' 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 mariner or by any means, except for 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.ahfidirectory.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. 02014 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: (394991315596410