HomeMy WebLinkAboutBuilding Permit Application i
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE.ACCEPTED
Date:_ 69• 1 �� Permit Number:
RECEIVED
Building Permit Application 1
Planning and DeveloprnentServices AUG 1 2017
Building and Code Regulation Division
2300 Virglnla Avenue,Fort Pierce FL.34982
Phone: (772)462-1553 Fax:(772)462-1578 Commercial � Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Address: N,G1W ". I
Legal Description:Wind t6 i iI IaAfa b aY
N
Property Tax ID#: - �" Lot No.
Site Plan.Name: Aes=� J'1 k—:( ! Block No_
Project Name:
Setbacks Front Back:_ Right Side: Left Side:
I d 1:151111511111 '1
t1 a wor obe.orformed un er s perm —c eta app y:
HVAC Ll Gas Tank ❑Gas Piping Shutters ❑Windows/Doors.
Electric Plumbing . O Sprinklers F Generator .0 Roof
Total Sq.Ft of Construction: / S .Ft.of First Floor:
Cost of Construction:$ g�� UtilitiestSewer OSeptic .Building Height:
Name e Hudki Name: ,�t
Address: Company: ` nid ;
City: ` 1 State•f' Address:
Zip Code: Fax:-77Z-_qq•-9'' n City: St
Phone No. :] Zip Code: i Fax r�` 2
E-Mail: Phone No.
Fill in fe imple True Holder o -next page(if different E-Mail:
from the Owner listed above) State or C linty license;
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address-
City: _ State: City: _ _ _ State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TiTLE HOLDER: —Not Applicable BONDING COMPANY: 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 represent tion 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
commencinR work or record' our Notice of Commencement.
k", s
_Signatu ner/Ix ee/Agent Signatppl ont actor/License Holder
STAT 0 RiDA ST OF FLORIDA
COUNTY OF JT LkkC COUNTY OF # LVC i e,
The forgoing instrument vias acknowledged before me The forgoing instrument was acknowledged before me
this_11_day of20iay this L( day of 4 20 M.. _by
Jrc �'rossyria n In �e C jos rn r�r,
(Name of person acl{nowledging) (Name of person cknowledging)
(Signature of Notary Public-State of Florida) (Sig ature of Notary Public-State of Florida}
Personally Known✓OR Produced Identification Personally Known OR Produced Identifieation
Type of identification Produced Type of Identification Produced
Commission No. OO commission No. FOO ate. ea
ISTINA L LOUDE CI:
Y KRiSTINq i.LOUDER CK r=� ?•E MY Commi N �;+ {i{
9222 ? EXPIFtES August 7. 7 E
EXPIRES Au uat 7.2017 a 9 2
'Revised 07/15/2014 g t Ott ss-01s3 Ftoddalloce scwtce.e.
Ab 398-0133 IF910 aN04h y6eNJCa,evm
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE '
COMPLETE
INITIALS
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1
Certificate of Product Ratim"
AHRI Certified Referdnce Number: 7615285 Date:4/20/2017
Product:Single-package Air-Conditioner,Air-Cooled
Model Number: P7RE-036K
Manufacturer: FRIGIDAIRE
Trade/Brand name:FRIGIDAIRE
Region:All(AK,AL,AR,AZ,CA,CO, CT,DC, DE,FL,GA, HI,ID, IL, IA, IN, KS, KY, LA, MA, MD,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 alr conditioners
can only be installed in region(s)for which they meet the regional efficiency requirement.
Series name: FRIGIDAIRE KRE SERIES
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"RaUnga followed by an asterisk(")indicate a voluntary re!ste of previously published date,unless accompanied wiih a WAS,which indicates an Involuntary terata.
blSC[AIMER
AHRI does not endorse the praduct(s)listed on this Certificate and makes no representations,warranties or 9uaraht1:=as to,and assumes no responsibility lot,
the product(s)listed on this Certificate.AHRI expressly disclaims all Ilabllity for damages of any kind atlsing out of the use or performance of the pioduct(s),or the
unauthorized alteration of data hated on this Certificate.Certified ratings are valid only far models and configurations listed in the
directory at www.ahrldlraetory.org_
TERMS AND CONDITIONS
This Certificate and its contents are proprietary products of AHRI.This Certificate shalt 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;dlaseminated;
entered into a computer database;of otherwise utilized,In any form or manner of by any means,except for the User`*indiVidual,
personal and confidential reference. A1R.CONDITIOMNrd,kEATING,
CERTIF'IcATE VERIFICATION &REFRIGERATION INSTITUTE
The Information for the model cited on this certificate can be verified at W WW.abridliaotot-y.org,click on'Verify Certificate"Iinli the make life bottet'"
and enter the AHRI Certl(t if Reference Number and the date on which the Certificate was Issued,
which is listed above,and the Certificate No.,which is listed at bottom right t ttt:xits:fr !,= ::_:;7 ;.-
072014.Air-Conditioning, Heating,and Refrigeration institute
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