HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE` INFO
MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number.
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Building Permit Application
Planning and Development Services
Building and Code Reguiation Division
2300 Virginia Avenue, Fort Pierce FL 34952
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPtICA T ION FOR: To Select from dropbox, click arrow at the end of line
Address:
Legal Description:
Property Tax ID #: �,P�3 2- Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
HVAC
Electric
L_I Gas Tank
ElPlumbing
Total Sq. Ft of Construction:
Wo
un er this perms - check all t= appy:
DGas Piping 11 Shutters Q windows/Doors
Sprinklers L1_j_I Generator 0 Roof Roof pitch
Cost of Construction: $
S. of First Floor:
Utilities:cnSewer OSeptic Building Height:
Name /- a j O&n -
Address: i J ani6 4 q
City: _peri- JS : r'.4c� er , State:
Zip Code: _7 Fax:
Phone No.Y0 7b -
E -Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Name:e,
Company: t.&G
Address: �.i S. -% ��cY� fg1/E:"
City: H State:per• -
Zip Code: Fax:
Phone No.1 � -- ,0 C
E -Mail: 6c/o-)'!4 eriz iJr Cq!y'
State or County License: Cl- _elf a y
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNERIENGINEER: � Not
Name:
Address:
City: P State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address: '
City:
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name: _
Address:
City
Zip;
certify that no work or installation has commenced prior to the issuance of a permit.
Phone:
St. Lucie County makes no representation 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 guying 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
commencing work or recording your Notice of Commencement.
Signifture of Owner/i_essee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF_ _5-: La
The forgoing instrument was acknowledged before me
this Zt�! day of '!&#- , 20r_by
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF T
The forgoing instrument was acknowledged before me
this ,eZ °!%y of i%r _ 20 t.,7 _ by
.J
(Name of person acknowledging) (Name of person acknowledging)
(Signature of NotaryPublic- State of
Personally Known OR•�od✓ 1 '
Type of Identification Produce
Commission No. �j�m7rcl.
�FF� eaJ1
9
Revised MP/15d2014
(Signature of N tao�i'y Public- State of 0, wo".1 '�49`
" AIS5fC3,�
Personally Known ✓ OR Pro&c Y a g '-
Type of Identification Produced Z '
Commission No. 6' nTy25�' egp ; �a
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
-SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
This combination qualifies for a Federal Energy
Efficiency Tax Credit when placed in service.
between Feb 17, 2009 and Dec 31, 2016.1
Certificate of Product Ratings
AHRI Certified Reference Number: 6892357 Date: 8/1112017
Product: Single -Package Air -Conditioner, Air -Cooled
Model Number: GPC1436H41D*
Manufacturer: GOODMAN MANUFACTURING CO., LP.
Trade/Brand name: GOODMAN; JANITROL; AMANA DISTINCTIONS; EVERREST; ONE HOUR AIR
CONDITIONING AND HEATING; ENERGI AIR; FRANKLIN
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 air conditioners
can only be installed in region(s) for which they meet the regional efficiency requirement.
Series name: GPC14
Manufacturer responsible for the rating of this system combination is GOODMAN MANUFACTURING CO., LP.
Rated as follows 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 (Btuh): 35600
EER Rating (Cooling): 12.00
SEER Rating (Cooling): 14.00
LEER Rating (Cooling):
"Ratings followed by an asterisk (•) indicate a voluntary rerate of previously published data, unless accompanied with a WAS, which indicates an involuntary rerate
DISCLAIMER
AHRI does not endorse the products) listed on this Certificate and makes no representations, warranties or guarantees as to, and assumes no responsibility for,
the product(s) listed on this Certificate_ AHRI expressly disclaims all liability for damages of any kind
arising out of the use or performance
unauthorized alteration of data listed on this Certificate. Certified ratings are valid only for models and configurations listed in the
of the product(s), or the
directory at www.ahridirectory.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 in part, be reproduced; copied; disseminated;
entered into a computer database; or otherwise utilized, in any form or manner or by any means, except for the user's individual,
personal and confidential reference.
AIR-CONDMONING, HEATING,
CERTIFICATE VERIFICATION
The information for the model cited on this certificate can be verified at www.ahrldirectory.org, click on "Verify Certificate" link
& REFRIGERATION INSTITUTE
and enter the AHRI Certified Reference Number and the date on which the certificate was issued,
we make €i€e better -
which is listed above, and the Certificate No., which is listed at bottom right.
02014 Air -Conditioning, Heating, and Refrigeration Institute
CERTIFICATE NO.:
13146938196720591