HomeMy WebLinkAboutBuilding Permit ApplictionALL APPLlCjkBLEfiNF0 MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: i Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fart Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from drophox, click arrow at the end of line A A
Address. 2-tO 5 ';i 4 vvi .i
Legal Description: M ),-Y'0,V i 1
Property Tax ID #: z y Z I -'6 QL—Cj C) -S b - Win_._ Lot No.i a _
Site Plan Name: Block No. 2—
Project
Project Name:
Setbacks Front Back: Right Side: Left Side:
PVIIO1 wU11% Lu ue FIUFfnea unaerLnis perm€t--ci
MVAC Gas Tank Gas Piping
Electric ® Plumbing 05prinklers
apply:
Shutters F, Windows/Doors
Generator 0 Roof = Roof pitch
Total Sq. Ft of Construction: S . Ft. of First Floor:
Cost of Construction: $ . ?�' Utilities: L_ISewer Septic Building Height:
1 R
Na
City:' Y State:L,
Zip Code: Fax
Phone No.2- 9
E -Mail:
Fill in fee simple Title Holder on neat page ( if different
from the Owner listed above)
N Tr
Name:
Company:,s
Address:1
City: E}CCC,.State: t -L �^
Zip Code: a149L Lp l=ax: -77 7q�� Z2
Phone No.
E -Mail:
State or County Llcense: Z x.
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: x Not Applicable
Name:
Address:
City:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone: _
State
x 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.
X Not Applicable
State:
X Not Applicable
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 recordin our Notice of Commencement.
re of Owner/Lessee/Contractor as Agent for Owner
STATE OF FLORIDA _
COUNTY OF 5 11 A C
The forgoing instrument was acknowledged before me
this day of 20 L —1by
cA
cense Holder
STATE OF FLORIDA
COUNTY OF ST-_
The forgoing instrument was acknowledged before me
this U day of RA 20 _!__L. by
1 F-1 t l F.
(Name of person acknowledging) (Name of person acknowledging)
Notary Public- State of Flori
Personally Know__ OR Produced Identification
Type of Identification
"1 SUSAN wNTENEGRO
•# GG 089099
Commission No. IMYCOM(5
rfe-_A MF_XPTh
�NIRE1Se;,�A€�3ri�1 y 2, 2021
Revised 07/15/2014
of Notary Public- State of
Personally Known OR Produced Identification
Type of Identifica on Produced
Commission No. «`" ,— SUSAN tj NEGRO
`; MY COMM lSS10N # GG089099
� `
+' el 2.2021
i ti..n .� ��'' Bonded Thru Notary Pubk Undorr Wr
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 E
Efficiency Tax Credit when placed in st
between Feb 17, 2009 and Dec 31,
Certificate of Product Ratings
AHRI Certified Reference Number: 8676079 Date: 7/6/2017
Product: Split System: Air -Cooled Condensing Unit, Coil with Blower
Outdoor Unit Model Number_ 4TTR6036JI
Indoor Unit Model Number: TEM4AOC42S41+TDR
Manufacturer: TRANS
Trade/Brand name: TRANS
Region: All (AK, AL, AR, AZ, CA, CO, CT, nC, CIE, pL, GA, HI, ID, IL, IA, IN, KS, KY, LA, MA, Min, 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: XR16
Manufacturer responsible for the rating of this system combination is TRANS
Rated as follows in accordance with AHRI Standard 2101.240-2008 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): 36400
EER bating (Cooling): 14.00
SEER Bating (Cooling): 17.00
IEER Rating (Cooling)_
' RallnBs lollowed by an asterisk (') indicate a voluntary ,Ambi of pmviously published data, unless Accompanied with a WAS, which indicates an involuntary rerafe
DISCLAIMER
AHRI does net endorse the prndfetfs) listed on this Certificate and makes no r¢pr"entationsi, Warranties or guarantees as to, and asstimes no responsiblfity for,
the product(s) Listed on this Certiflrate- A41R1 expressly disclaims all liability for damages of any kind arising out of the use or performance of the producus), or the
auth-eyed alteration of data listed on this Certificate. Certified ratings are valid only for models and configurations listed in the
directory at www.ahridireetary.org.
TERMS AND CONDITIONS AINA120
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 dataas base, ataba, at attic se utilised, In any form or manner or by any means, except tot the user's Individual,
personal and confidenttai reference. AIR CoR 0
CERTIFICATE VERIFICATION
The information forthe 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 dare on which the certificate was issued,
which is listed ebove, and the Certificate No., which is listed at botWm right. i--
02014 Air -Conditioning, heating, and Refrigeration Institute CERTIFICATE NO--
Into INE, HEATING,
& REFRUNtRATION liipr lT e
,,, T"k, till iu,cre
13143828232,9963647