HomeMy WebLinkAboutBuilding Permit Application INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Y VT
. c.Permit Number:
RECEIVEN
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'Building Permit Application
i Jevelopment Services 2017
",Ode Regulation Division
Avenue,Fort Pierce FL 34982
462-ISS3 Fax;(772)
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1PLICATION FOR'. To Select from dropbox, click arrow at the end of line
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1975 SQ.Ft.of First Floor:
• " • 4100.00Utilities: ■Sewer 0Septic Building Height:--7 1
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Jul 31 2017 6:39PM HP Fax page 2
REM
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D SIG ER_E GINEER: —Not Applicable MORTGAGE COMPANY: :Not ppii ble
N rne:, Name:
A dre Address:
Ct State: City- State
Zi Phone: Zip: Phone:
FE SI PuE i ITLE HOLDER: —Not Applicable BONDING COMPANY: —Not ii ppll le
N me:i Name:
A dre . : Address:
C• y: aty,
Zi Phone: Zip: Phone'
I owtify¢hat no workor installation has commenced priorto the Issuance of permit.
St.Luciejtount makes no representation that is granting a�ermit will authorize the permit holder to build the_sub ss� re
wh ch is to con ct with any applicable Home Owners Association rules,bylaws or and covenants that may restrict prohi 't su h
str cturt.Plea consult with your Home Owners Association and review your deed for any restrictions which may pply.
In ons! eratiot of the granting of this,requested permit,I do hereby agree that I will,in all respects,perform the rk
in i iccor I
ante v ith the approved plans,the Florida Building Codes and St.Lucie County Amendments.
Th faling b jilding permit applications are exempt from undergoing a full concurrency review:room additions,
ao essoiY strue ures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-resider tial use
WRNING T OWNER:Your failure to Record a Notice of Commencement may result in your paying ice f
i romen s to your,property.A Notice of Commencement must be recorded and posted on t e job ite
be or!11h e fi st inspection. If you intend to obtain financing,consult with lender or an attorney fore
co nmoncinglwork or recording our Notice of Commencement,
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SI natur ofner/lessee/Contractor as Agent for Owner Signature of ContractorAlcense Holder
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S. ATE OF FLORIDA STATE OF FLORIDA
C LINTY OF 64 , Lvc to COUNTY OF L y re
TI e f oy►g i strument was acknowledged before me The forgoing instrument was acknowledged be a me
IS say iJ v,4 20 Llby this 31 day of v ty 20 i7
1 e r Rem'11 S `Z b e r e AA 15
(Name person acknowledging) (Name of person acknowledging}
(Signat4re of fi otary Public-State of Florida} (Signature of Notary Public-State of Florida}
Persona y Known ' ,�Q6t,'�cpduced 1det9Llf�ll1*Ry0N Personally Known x OR P o ueed Identification
Type of entifl tion Onsd °=% NDtar Public-State lorida Type of identification Pro duced•
*y ; My Comm.Expires 00.13,2018 �'°Y°��1;•s, R
C mmis ion tv 3 3 5$.Q=: CoB}on#FF 133580 Commission No. l 5 Sa i�' fary Pu iic-Sate of tido
r • . Comm.Expire ocl 1 2018
. . 9:+•k�dThrwghNalionalM1'ataryAs50. %� •��.:
w1iwal omni ion# FF 13 0
Ivul Assn.
evised 07 15/2014
EVIE S FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW RqVIEW
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Jul 31 2017 6:40PM HP Fax page 3
it "ICIP
ert ficate of Product Ratinela
HRI Certs led Reference Number: 7502926 Date: 7/31/2017
Product:Split System:Air-Cooled Condensing Unit,Coll with Blower
Outdoor Un It Model Number.4VA40481.1
Indoor Unit Model Number:TEM4AOC48S41+TDR
anufactur r:AMERICAN STANDARD
rade/Bran name:AMERICAN STANDARD
egion:All AK,AL,AR,AZ,CA,CO,CT,DC, DE,FL,GA,HI, ID,IL, IA,-IN,KS, KY,LA, MA, MD,ME,
I,MN,MO MS,MT,INC,ND,NE,NH,NJ,NM, NV,NY,ON,OK, OR, PA, Ri,SC,SD,TN,TX,
T.VA,VT,WA,WV,VA,WY,U.S.Territories)
egion Note: Central air conditioners manufactured prior to January 1, 2015,are eligible to be
i stalled in all regions until June 30,2016. Beginning July 1,2016,central air conditioners
n only be installed in regions)for which they meet the regional efficiency requirement.
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i ER Rating'(Cooling):
tangs followed an astadsk r)Indicate a voluntary rerate of previously published data,unless accompanied Win a WAS,which indicates an involuntary rerate.
D$CLAIMER
RI does not en me the product(s)istod on this Certificate and makes no representations,warranties or guarantees as to,and assumes no re6portsiblitj for,
It products)It on this Certificate.AHRI expressly discialins all liabilityfor damages of any kind arising out of the use or performance of the product(s), r the
u authorized elle Ion of data psted on this Certificate.Certified ratings are valid only for models and configurations listed in the
dl etoryatwww. hrfdlrectory.org,
T RMS AND CO DITIONS
is Certificate an its contents are proprietary products of AHRL This Cerdfieate shall only be used for Individual,personal and
c nfidential refere ce purposes.Tho contents of this Certificate may not,in whole or in part,be reproduced;copied;disseminated;
et tered Into a c puler database;or otherwise utilized,in any farm or manner or by any means,except for the user's individual,
pi rsonal and confl lentlall reference. AIR-CONDITIONING_ BATING.
C IRTIFICATEVE 11FICATION &REFRIGEROMIONI TITUTE
O Information to the model creed on this certificate can be vedtfed at www.ahridirectory.org,click on'Verify Carttficate”link v,;e make life het r^
a d enter the AHR Certified Reference Number and the date on which the certificate was Issued,
rich is listed abo e,and the Certificate No.,which Is listed at bottom right r , r v:•, T:
Cc P 2014 Air ditioning,Heating,and Refrigeration Institute