HomeMy WebLinkAboutBuilding Permit ApplicationAI III y 'Ifll' MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
ALLAPPLI LE NFO
Date: I 1 Permit Number:
'� ;r a• a :�+
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 X
d PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line Mechanicp
•4''L7€A@INt1iA'L�.��"IOIAid,RlFf`.'aS 'r'ra ,1�!?r� tt�� 5 P4ldY�OQ SjIFY� {Fri s9S'r ''s::;�:'
,........r.,........., ..................... _ _.._- ,....... .,..t�1Y !� �q' 1�'r14iA 7�fAM? , . �')'��.r' ^', t .. i. -h11....... . d..4 't :e -:.:
Address: U (31 A\ CxQ y1 A Y \ CA C ,1 r
Legal Description: Pa\m GrO V C. !I BI�K LOT 7
Property Tax IDtf:.2iL1tD '7i. 0,F) D H4 -X03 -.3
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side:
I .,�.�, ..Mx!' i�-nam
gym, : r.�.� '�� ;5�... �'%f_�,.�.. �` .'�r . `t .iM'd': ic(p4'
.i. "Ai 'rJ Jhi+�:�:�j?iry Sl,`y1;�4:
\V%S-%S0kY% on O � I i Y-2 f'O,c GV -J--
P vM-n V ; 14 S•EE-K W 'i t\\ 5 KW
Gas Tank
Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ L-1. ZOO .0O
Name, 1-1(lYlt)l f -I
Address: loi31 AlcXnrYiYiCX C_i W�
Left Side:
3 TON TRF% N -t
e\ec4-rim I�es��
Lot No. -]
Block No. i=
1
Piping UShutters ❑Windows/Doors
nklers Generator Roof C� Roof pitch
SQ. Ft. of First Floor:
Utilities: 0Sewer0Septic Building Height:
city: IF+- p%PXC.P. Stater
Zip Code: -51,4C1167- Fax: N fa
Phone No. -11 ?_ - -, 2) 9 - III L-1 R
E -Mail: N A,
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
_ . al7i�,�m MIME, 3 ,
Name:I\IAJIV\f.� F rwvv�t'.S
Company:j�Yl�V\CS:'1-\fYa}iy\q� %�1C
Address:�50,: 4 N lAC ll�nl�l \
City: 0r. P1CC_P. State:l-L
Zip Code: ?iy A 4 Lr Fax: -7-77_- LA Wk - 4rt LZ
Phone No.�'(�_-LA lol- B"itt
E-Mail:A�`O�(Y.rtv�nP.S,(�„��r�l.
State or County License: 9-A, h1714, O'i \
If value of construction is $2500 or more, a RECO RUE .0 Notrlce otLommencernent If required.
DES GNER/ENGINEER:
x Not Applicable
MORTGAGE COMPANY:
x Not Applicable
_
Name:
—
Name:
Address:
Address:
City:
State:
City:
State: _
Zip; Phone:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
x Not Applicable
BONDING COMPANY:
x 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 the permit holder to build the subject structure
which is in contlict 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 finalcing, consult with lender or an attorney before
fommencing work or recording your Notice of Comme cement.
na ure of Owner/Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF <�T • LU.0 1 C
The forgoing instrument was acknowledged before me
this1-7 day of IxAI\i . 20 jZby
J ik{�ES F
(Name
eooff pp'e'rrs_oonnn acknowledging)
,45gnature of Notary Public- State o dif F ro iF ro i A
Personally Knowrl\�___� OR Produced Identification
Type of Identification -A
"�"•• SUSAN MONTENEGHV
`tr' ;At'•s
Commission No. :`? MYCOION #GO089099
�i EXPIRES: APO 2.2�0�2�11
••1,FOi•�9a ThN NOWY PV*UM& *M
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR
COUNTER REVIEW REVIEW
DATE
COMPLETE
INITIALS
_
5 ature of Contractor/License o der
STATE OF FLORIDA
COUNTY OF ST. LUC_kE
The forgoing instrument was acknowledged before me
this 0 day of Ju"\il! , 20 =by
S Pc i�l ES F G�1 I^/1 F C
(Name of person acknowledging )
—_(Signature o Notary Pu lic- State of Florida}
Personally Known OR Produced Identification
Type of Identifica on Produced
Commission No. .+'1'i' SUSAN ("NEGRO
r 4 MY Cj�061MyIESSS.IOMN k GG 089099
gondeb Thru Ho PaEk. 2027
tery UMe�writcrs
PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW
A
Certificate ®f Product Ratings
AHRI Certified Reference Number: 7921586 Date: 7114/2017
Product: Split System: Heat Pump with Remote Outdoor Unit -Air -Source "
Outdoor Unit Model Number. 4TWR4036D1
Manufacturer: TRANE -
Indoor Unit Model Number: TMM5AOB36M31SAA
Manufacturer: TRANE -
TradelBrand name: TRANE
Series name: XR14
Manufacturer responsible for the rating of this system combination is TRANE
Rated 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 (Stuh):
34000
EER Rating (Cooling):
12.00
SEER Rating (Cooling):
14.00
Heating Capacity(Btuh) @ 47 F:
34000 5
Region N HSPF Rating (Heating):
8.20 -
Heating Capacity(Stuh) @ 17 F:
21000
aeenct hAaieU by an assmar(') indiale a Mlmlaryterata, of plevbusly ploblithed data ,takes, a,cmyanlaU with x WAS, wlhCh inJitslas an iovolunlary none, -
DISC411MER
AHRI does not moderate the pmdudes) listed on this Cenlf tale and makes no representations, warranties or guarantees as to, and assumes no mepenslMllry Ing,
-
In. onom.bg listed on this Certlfical AHRI eaprassly druseinw all liability for damages of any end arising out of the use or parf.no.no. of the postulant), m the
- unauthorized alteration of data head an IM16 Cern)- e. CenMed ratings are valla only for models and configurations lethal In the -
Mrecleryat wwiolm nelreclory.erg.
TERMS AND CONDITIONS
Thus Certificate ..oil. contents are moodeboy areducb of AHRI. This CtdlOcaW,ha0 anly be used far indlykiml, personal and Oft-
Confldenlr.L reference porbasea. Tile CenRnls of Nls Conl4ole may xol in whole or lnpan. be mpaduced: eoplrll: llasemIrmado On
enleM into a computer mothafe: or olherwlN utilized. In any form M manner or by any means. Adana for me user 5 lndMdual, Ie_COxdIT10NIMG. xE411nG. -
'in -mor
sari cumnnomiol.1... ncc.
- CERTIFICATE VERIFICATION s asra.sraaox l tommm, -
- Taelmanowilon ror Ina model own on Ibis cegnllcata con M verlfrcal at wxw.anrltllreeimry.ora, dice on NerrN Cern/iCet� lints .
and enter the ANRI Conn. RelnenR' Number and the data an which the Corrb,sle wag issued
which Is listed above, and the Certihcate No.. whkh is listed e1 haft. right. 131645208822333937
02014 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: -