HomeMy WebLinkAboutBuilding Permit Applicationn
ALL APPLIC BL NFO MUST BE COMPLETED FOR APPDate:
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 3491g2
Phone:, (772) 462-1553 Fax: (772) 462-15 78
I,,ICATION TO BE ACCEPTED
Permifi Number
ddress, L
.anal Descr
Property
Site Plan
ion*
olp '0y
Tax ID #:
Name:
Project Name:
Setbacks
1p
y ■ �a -+� _ ,.ice.
Back
Right Side: Left Side:
Res'ldent*la
Lot No,,
Block No.
- -
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errormeci undertnis per it check all'that
02 y flb
Gas Tank
Plumbing rinlders
Gas Piping
Ft of Construction:
Cost of Co
Name
Addr
City;
Zip C
nstruction, $
`ab 1 $
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Shutters
Generator
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Ut*llitles:
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Phone No4'
E -Mail:
RON W_
Fill in fee simple Title Holder on ne pageiff different
from the Owner listed above)
If value of construction is $2500 0
r more,
44 dt
Name:
Company:
Address:di
City:
Zip Code.•
Phone No,
E -Mail: 36
State or County License,.
st Floor.*
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Roof pitch
a RECORDED Notice of Commencement is raga
fired.
Fax
t �
Statel.1p
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D�ESIGNER/ENGINEER, Not
Applicablt
:6 x Not Applicable
Name.,
Namet
Ad'dress: Address
- .
C,ly t y
State C
1 y:9K
zip* - -
Phone.
zipm one.
NRN
FEE SIMPLE TITLE HOLDER: x Not Appli*cable`
N a e:.
Name.,
°
Address,Address.,
City:@
C t
ZI
.-
zer
. - -
Ph
Pone.
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Phone.
I
1 certify that no work or installation has commenced prior to theissuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize ther, M't holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrir_t or nrnhih�t c� �rt,
structure. P ease consult with your Home Owners Association and review vo u r deed'
for anv
In consideration of t
in accordance with t
restrictions which may apply.
he granting of this requested permit, I do herebagree that I will, in all respects, p%I'we
he approved plans, the Florida Building Codes any
d St. Lucie County Amendments.'
Thpfnllnuiinah��ilrl�.,�..or.,,.t+-,.,.,1:,...+;,,.....,�..,......Y_�r__.v.._r____.___r._��
concurrency
form the work
o �w������5 N�1 I I I�� ONN���auv��� arc c�cciriN� ir�rri unaergoing 8 7U11 P2VI2W. 1'00171 8dtilLlOf1S,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential usa
WARNING YO OWNER: Your failure tc Record a Notice of Cnmmpncpmpr,t mav
improvements to your prop
before the first *inspection..
r esult in vour oavinLy twice fr,r
erty. A Notice of Commencement must be recorded and posted on the j*obs'l'te
f you intend to obtain financing, consult with lender or an attorney before
commencing, work or recording your Notice of Commencement.
nature of Owner/Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF
i
The forgoing instrument was acknowledged before me
this � da y of L\X 1 , 20 k by
ignature of Notary Public- State of Floridl)
Personally Known>4::::� OR P
Type of Identification ELQdl
roduced Identification
SjSAN moNTENEGRO'
089099
Commission N()G# Ah At MY cow
EXPIRES: 212:4
Sv�dw TNU twjq pikk
S' ature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF < `0
The forgoing instr
thisday;�M. 4� of _
umen
t was
•e
y
L
O
acknowledged, before me
f�RS�4
(Name of person acknowledging)
Signature of Notary Public- State of Florida
Personally KnowProduced—__- OR Produced Identification
Type of Identfficaton
Commission No., .t 1, SUSAN (TSANEGRO
°iL''' MY COMMISSiON # GG 089099
XEIR I AD(d2.20/21
d Trn Nouq Pubk UrKWMiLws
This combination qualifies for a Federal EnergyEffiicency Tax Credit when placed �n service
between Feb 17s 2009 and Dec 31, 2016*
Date'm: 7/26/2017
Product;* Split System: Air -Cooled Condensing Unit, Coll.with Blower
Outdoor Unit Model Number: 4TTR6049A
a A.
rT#
nv�F
Manufacturer.* TRANE
Region: Al. (AK, AL, AR, AZ, CA, CO, CT, DC, DE, PL, GA, HI, ID, IL, tA, IN, KS, KY, LA, MA, MD, ME,
MI: MN, MO, MS, MT, NG, ND, N£, NH, NJ, NM, NV., NY, OH, OK, OR,, PA, R1, SC, SD, TN, TX,
UT, VA, VT, WA, WV,, W!, WY, U.S. Territories)
Reg'*on Note: Central air conditioners manufactured prs+�r to Januar,� 1, 201 �, are eligible be
installed �n all regions �ntit�J�urt� 30, 2016. Beg-innin� July '�, 2016, central air conditioners
��� an��r be installed in region(s) for which they meet the regional efficiency requiremen#.
Series name XR16
Manufacturer responsible for the rating of thisisystem combina#ion is TRANS
Rated as follows in accordance with AHRI Standard 2i0/240-2008 for Unitary Air -Conditioning and Air -Source
Heat Pump Equipment and subject to verification of rating accuracy by AHRIosponsored, independent, third
party testing:
Cooling Capacity (Btuh):
EER Racing (Cooling);
SEER Rating (Cooling):
1EER Rating (Cooling):
U04101lipi
' Ratings folf0wed by an asterisk *rindicate a voluntary rerate Qf previously published data, unless aecompanip.d with a WAS, whichindicates
DISCLAIMER
AMR[ does not endorse the product(s) lamed on this Certificate avid fnakes no representatfons., warranties or guarantees as to, and assumes no responsibility
the r 11sted on thisCertificate. AHRI expressly disclaims all11aWflity for da.mages of any kind, arising out of the use or perfo-rmance of the product(s), or the
unauthorized alteration of data listed . Cued ratings are valid . for models and configurations i
isted in the
directory at W,wwa h rid! rectory;erg.
TERMS AND CONDITIONS
This Certificate and its contents are proprietary rad HRL This i t a
personal and
confidential reference purposes.., The contents of thi
rpt may .got,. Irt whole or in part, be rprdR led; -disseminate
amara Into a computer database# -r otheriWise utilized, in any form or manner or by any means, for '
1,
personal and canfidential reference,.
CERTIFICATE VERIFICATION
The information for the mode.. cited on this certificate can be varifted at www.ahrtLdireotory.org,i on uverifyrt l * IM4,
and enter the A HRI Certified Reference Number and the date on which the certificate vaus issued,
which Is listed above, and the Certificate No., which is listed at bottom right
Vjejej4gewratj-0Tj JnStj4tUte
C'EaT IC411E KG*W
AI-COIIv REATING,
REFRIGERATION
I, AL V --* b
131455507228544522
i nis combinmiion qualifies for a Federal Energy
Efficiency Tax Credit when placed in service
between Feb 17.� 2009 and Doc 31,2016,
AHRI Certified. Reference Number: 8626iOl Date.: 7/216V2017
Product: Split System: Air -Cooled Condensing Unit., Coil with Blower
Outdoor Unit Model Number:: 4TT1M%.1024,11
Manufacturer: TRANE
Trade/Brand names. TRANE
WPft
Region: All (AKAL, AR, A2, CA, CO, CT, AC, DE, FL, GA, Hl, ll], ILv IA, IN, KS, KY
'I LA,, MA, MD., ME,
MI, MN, MO, MS, MT, NG, ND, NE,, NH, NJ, NM, NV., NY., OH., OK, OR, PA. R151 SC, SD, TN, TX,
WUT, VA, VT, WA, WV, W-11l,Y, 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-k. Beginning July 1, 2016, central air conditioners
can only be installed in region(s) for which they meet the regional efficiency requirement.
1XR16
Series name,
Manufacturer responsible for the rat�ng of this system camb'ination IsTRA NE
Rated as follows in accordance with AHRI Standard 210/2404008 for Unitary Air=Cflnd�i4i�i�'fg a1"1d 14�r-mS�W�'��
Heat Pump EquiP ment and subject to verification of rating, accuracy -by- AHRksponsored, In'dependent� third
party testing:
Gaoling Capacity (Btuh):
EER,Rating (Cooling);
SEER Rating (Cooling):
LEER Rating (Cool'ng):
Ratings followed by an asterisk (*) inclic �dy IL
ished data, unieza accompanied with a WAS,whi indicates an involuntary taste}
DISCLAIMER
AHRI -does not endure the p listed on this Cerfificate and makes no representations., r r guararrtees as t
the product(s) listed on this Gettificate. AHRI expressly dfsola[rns all liability for damages of any kind arising out of the use or performance ofthe product(s), or the
unauthorized alteration of data fisted on this Ce cate, Certified ratings are valid only for modeLs and confir i listed 'in the
hector t w -. r r r. r;
This Certificate and contents are proprietary ro I. This leaf � l only for 4 i i l personal and
:
confidenbi reference purposes The contents of this Certificate may nott in whole or in part, be repro(luced., copied; disseminated
,enteredkoss i�
I t i any form manner r b means . #or the user# I
r ill 'Confi den t i a l reference,. AJR-CONwTWNIrATINoy
CERTIFICATE VERIFICATION & REEFRIGMATWNITT
The information for the model cited on this certificate can be verified t -r it - r ,.r�,Fclick n aVerify r fi t" Fink
and enter the I Certified f re Number and t ate o h the certificate wasis$ued.,
which Hated above, and the Certiftate No., Which 'is listed at bottom right.
02014 Mr -Conditioning, Hea-Ung, and Refrigeratton Institute
w_. •.... �... _9.—vti•.w,-..:.v. a-.,o,i...ea-.•a�-�Y-MF�nNesH�Tv�r�raaa{aL.n,.�....�.�JY" � —e �cr.� - .
CERTIFICATE NU.: