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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date:6 'atz) ` ao ) 'i Permit Number. 777 00s 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 here PROPOSED INPROVEMENT LOCATION: AJc, Q-An- 0l-"' Address: \ d 11 <; �A 12— 92� Q4[�TL IA Legal Description: Property Tax ID #:4 �JU� - -31 c) - Un I © orX ) � 4 Lot No. Site Pian Name: "-LC I, aQ Block No. Project Name: (='' �1 C`I3 J ( u -I. ao- Setbacks Front Back: Right Side: Left Side: itiona work to be rtormed Gas Tank under tnis permit - cnecK an appry: ❑Gas Piping Shutters ❑ Windows/Doors Name: CHARLES SEBOUT Company: AMBER REFRIGERATION Address: 10 D St,c�c� p�� Lfl City: '71 N!S?I�-► ) i State: FL Zip Code: 3`�� �� Fax: HVAC Electric F]Plumbing Phone No.'s �Ql L E -Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) Sprinklers _ ElGenerator Roof Total Sq. Ft of Construction: Or c4l,��- Sq- Ft. of First Floor: Cost of Construction: S � 3 f -!?:>S Utilities: 0 Sewer 0 Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name -3L. t- FQ13'i Name: CHARLES SEBOUT Company: AMBER REFRIGERATION Address: 10 D St,c�c� p�� Lfl City: '71 N!S?I�-► ) i State: FL Zip Code: 3`�� �� Fax: Address: 504 SW LAKE MANATEE WAY City: PORT ST. LUCIE State: FL Phone No.'s �Ql L E -Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) Zip Code: 34986 Fax: Phone No. 772-528-5986 E -Mail: amberrefFigeration@yahoo.com State or County License: CAC 1814270 if value of construction is S2s00 or more, a RECURutu Noi1ce or tommencemcm ns rcyuueu. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable Name: MORTGAGE COMPANY: _ Not Applicable Name: Address: Address: City: State: Zip: Phone: City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: BONDING COMPANY: _Not Applicable Name: Address: City: Address: City: Zip: Phone: Zip: Phone: OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated. 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, 1 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. Signature of Owner/ Agent/ Lessee Signature ofrontractor/License Holder STATE OF FLORIDA, , STATE OF FLORID . COUNTY OF GL COUNTY OF } Lucc The f $$�,,ing instru nt was acknowled ed before me this(`h2fay of 20� by 0 _� n c IkL�q __'Be x-t� (Name of person acknowledging) / n, (Signature of Notary :Publicte of Florida ) Personally Known OR Produced Identification Type of Identification Produced _ _ _ �_�Ahmi The fofgging instrument was acknowledged before me this j_ ay of %2UA.Q, 20 1by (Name of person ac nowledging ) (Signature of Notary Public- State of Florida ) Personally Known ✓ OR Produced Identification Type of Identification I2_roduq&d _ ��„ y (%W§BELL Commissio NQ.•`'a+PJ'•. DEBORAH Commission No. ?_�• • Notary Public - State of Florida ' = ion # FF 179630 • res Nov 30. Revised /1�i�, My Comm. Exp (ELiJARAH RUSSELL Notary Public - State of Florida Commission # FF 179630 My Comm. Expires Nov 30. 201 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED 11 Certificate of Product Ratinas AHRI Certified Reference Number: 8875405 Date: 6/20/2017 Product: Split System: Air -Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: 4A7A606OJ1 Indoor Unit Model Number: TEM6AOC6OH51+TDR+DF Manufacturer: AMERICAN STANDARD Trade/Brand name: AMERICAN STANDARD 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: SILVER 16 Manufacturer responsible for the rating of this system combination is AMERICAN STANDARD 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): 55000 EER Rating (Cooling): 12.50 SEER Rating (Cooling): 15.00 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. 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 onty 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 database; .� a computer or otherwise utilized, in any form or manner 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.ahridirectory.org, dick on "Verify Certificate" link and enter the AHRI Certified Reference Number and the date on which the certificate was issued. �,� make life better" which is listed above. and the Certificate No., which is listed at bottom right ©2014 Air -Conditioning, Heating, and Refrigeration Institute f CERTIFICATE NO.: 131424377645007.