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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICAB INFO 'UST BE COMPLETED FOR APPLICATIC N TO BE ACCEPTED Date; �/�� 7 Permit Number: w Planning and Development Services Building Permit Application Building and Cade Regulation Divislon 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 452-1553 Fax: (772) 462.1578 Ci mmercial . Residential PER APPLICATION FOR: To Select from dropbcx, elicit here PR©POSED 1pN`PAbVEEMtNT LOCATION: Address: Le aI ©�scrlption: 7.� t f f _ 1 - Property Tax ID M. o� ,f _ �� ge,(U_ MOO Lot Na. Site Plan !Name: Project Name: Block No, Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTI'N OF V110RK: a8 ACd AV kl " .ICA , kAl EONSTRUCTiON iNPORMq,TION: A ditian orkto be ertormed under this permit- ciseclt al� apply: HVAC Gas Tank Gas Piping p g Shutters � f 11 Windows Doors Electric Plumbing Sprinklers Generator Roof Total Sq. Ft of Construction: S Ft. of First Floor: Cost of Construction: $ Utilities: 0_SepticBuilding Height: OWN ER/I ESS E. Namet,�� C NTRACTC3R: <` Address: J//1� : D .�Yll W 1C fLS may: 1( n Cit �' ' , CLVUna i, r\ ail' y; Lam. State° kcadrr� isr~� Zip Code. /5+. Fax: CH y: 0j' `� F ISC' Phone No. %i� �, L�i�_�-P . Stater . Zig. Code:' Fax E -Mail: PhoneNo Fill in fee simple Title Holder on next page ( If different -Mail: �1iY1G(Y1C� from the Owner listed above) t � Stcte or County License: If value of construction Is $2500 or more, a RECORDED N of Coir encemernt�, is requ' d, Cit lov'10f�14 SUPPLEMENTAL CONSTRUCTION LIEN LAIN INFORMATION. DESIGNER/ENGINEER: _ Not Applicable IV ORTGAGE COMPANY: Name: Address: City: Zip: Phone: FEE SIMPLE TITLE HOLDER: Name: Address: City: Zip: Phone: State — Not Applicable N )me: Address: City: Zi p: Phone: BONDING COMPANY: N,3rne: Address: City: Zi:): Phone: I certify that no work or installation has commenced prior to the issuance of a permit. Not Applicable State: Not Applicable St. Lucie County makes no representation that is granting a permit wil authorize thepermit holder to build the subject structure which is in conflict with any applicable Home Owners Association rule.;, bylaws or and covenants that may restrict or prohibit such structure. Please consult with your Home Owners Association and rev ew 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 anc St. Lucie County Amendments. The following building permit applications are exempt from undergoir g a full concurrency review: room additions, accessory structures, swimming pools, fences, walls, signs, screen roo ns 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 Commencem nt must be recorded and posted on the jobsite before a first inspection. If you intend to obtain financin , consul n attorney before co enci r< or recorc i ur Notice of Commence _ Signature of Owner/ Lessee/Agent Sig ature of Contactor /License Holder`"` C STATE OF FLORIDA ST TE OF FLOR `4V'' � 4? A � COUNTY OF -3 C LUNTY OF The f r o �g instrurr was acknowledged before rr� ¢_ this NY of ' J it 20 z L Cr `cis k a �111kkigJ/ (Name fperson acknowled Ong) `` (Signature of Notary Public- State of Florida ) Personally Known OR Produced Identification Type of Identification Produced Commission No.F V_/� () {Seal) Revised 07/15/2014 REVIEWS FRONT ZONING COUNTER REVIEW DATE COMPLETE INITIALS Th(! forgoi g instrum�� s acknowledged before m o thi, ay of `4�LZlr 20 by o o D_ �:S o'n 1 Q '£ cy4 a, x Ll (Narne of rson acknowledging) da Pry( 1 mature ,%l - ( e of Notary Public State of Florida � Y Personally Known L --'OR Produced identification Type of Identification Produced Commission No. r', qr7 , d (Seal) SUPERVISOR PIANS VEGETATION SEA TURTLE MANGROVE REVIEW REVIEW REVIEW REVIEW REVIEW �..1u-SGC-'` t '�J � rf �� ��'✓'�- , Certificate of Product Ratings AHRI Certified Reference Number: 9139639 Date: 7/17/2017 Product: Split System: Heat Pump with Remote Outdoor Unit -Air -Source Outdoor Unit Model Number: 14HPX-030-230-21 Indoor Unit Model Number: CBX32M-030*+TDR Manufacturer: LENNOX INDUSTRIES, INC. Trade/Brand name: LENNOX Series name: MERIT 14HPX SERIES Manufacturer responsible for the rating of this system c :limbination is LENNOX INDUSTRIES, INC. Rated as follows in accordance with AHRI Standard 210240-2008 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 (Btl 29200 EER Rating (Cooling): 12.50 SEER Rating (Cooling): 14.50 Heating Capacity(Btuh) @ 47 F: 26200 Region iV HSPF Rating (Heating): 8.70 Heating Capacity(Btuh) @ 17 F: 16900 " Ratrngs followed by an asterisk (*) indicate a voluntary rerate of previously published data, or less accompanied with a WAS, which indicates an involuntary rerate. DISCLAIMER AHRI does not endorse the products) listed on this Certificate and makes no represeraations, warranties or guarantees as to, and assumes no responsibility for, the product(s) listed on this Certificate. AHRI expressly disclaims all liability for damal 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 onh for models and configurations listed in the directory at www.abridirectory.org. TERMS AND CONDITIONS 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 ii i part, be reproduced; copied; disseminated; entered into a computer database; or otherwise utilized, in any form or manner or by zmy 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 he verified at www.ahvidieractory.org, click on "Verify Certificate" link we make iife better" and enter the AHRI Certified Reference Number and the date on which the certificatl issued, which is listed above, and the Certificate No., which is listed at bottom right. 92014 Air -Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 131447949111734168