HomeMy WebLinkAboutBUILDING PERMIT ALL APPUC LE NFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 2 1 Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-15-18 Commercial K Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line e
Address: Sb S5 N rR \A $$ INS C
Legal Description: ?)YN Y\ MAW Y () C CQ,r T)W e vS 11 t �fILQ C- 1, nJ —
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Property Tax ID#: I4 I'-1 -l4 D l - D I`I S - bC7D- S Lot No.
Site Plan Name: Block No.
Project Name:
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HVAC Gas Tank ❑Gas Piping _ShuttersB Windows/Doors +
Electric Q Plumbing []Sprinklers 11 Generator Roof Roof pitch
Total Sq.Ft of Construction: So.Ft.of First Floor:
5 Cost of Construction;$ 11 l D -un Utilities: Sewer QSeptic Building Height:
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Name LCnlnca SC IQ u%i I e—K Name: (�Qtnn_t5 F .
Address:_5 655 fV i°l 81L 1 bS Company:f i nn C5.` 1-}el
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City:i=} _Pi P.y t Stater Address:ZhSLI N UA, � �\
Zip Code:-�4q 4q Fax: City: f-}, h r - State:F
Phone No.2 l 7 -r_I i a rS - 35 0 S Zip Code:314!3 Li U Fax: -I:l 7 -y l i l - St-t LZ
E-Mail: Phone No._]1-7 - f-tto l - B'1 i t
Fill in fee simple Title Holder on next page(If different E-Mali: u
from the Owner listed above) State or County License:
Ill of construction is$Z500 or more,a RECORDED Notice of Commencement is required.
`SUPPLEMENTAL,CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x 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 Count makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in convict 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
commencing work or recoorrdin your Notice of Commencement.
�y s
nature of Owner/Lessee/Contractor as Agent for Owner S' ature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Sr, u) L lE COUNTY OF St - Lu c 1 F
The forgoing instrument was acknowledged before me The forgoing instrument was ackpowledged before me
thisdayofn 20lZby thislz day of �S 20 Eby
,) �}�VuIES F G�-IVIES J �V�CS F ( �1f"LE.S
(Name of person acknowledging) (Name of person acknowledging)
nature of Notary Public-State of Florid ) Signature of Notary Public-State of Florida
Personally Knowq�___� OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identifica on Produced
•;p':og,., SUSANMONTENE
Commission No. A %° MY CO #GG089M Commission No.
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`'„"o::::••' is j,;r+1\\,'` SUSANI NEGRO
EXPIRES:A2,2021 M4OYCAIMISSION#GG89
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Revised 07/15/2014 , n No aryPbCUW +ers REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
This combination qualifies for a Federal Energy
AngluRal CERTIFIED' Efficiency Tax Credit when placed in service
between Feb 17,2009 and Dec 31,2016.
Certificate of Product Ratings
AHRI Certified Reference Number:7932234 Date:8/11/2017
Product:Split System:Air-Cooled Condensing Unit,Coil with Blower
Outdoor Unit Model Number.4TTR6030B1
Manufacturer:TRANE
Indoor Unit Model Number:TMM5A0B30M21 SAA
Manufacturer:TRANE
Trade/Brand name:TRANE
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,ON,OK,OR,PA,RI,SC,SO,TN,TX,
UT,VA,VT,WA,Will,WI,VVY,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:XR16
Manufacturer responsible for the rating of this system combination is TRANE
Rated as follows In accordance with AHRI Standard 2101240.2008 for Unitarryy Air-Conditioning and Air-SourceHeat Pump Equipment and subject to verification of rating accuracy by AN 1I ponsored,independent,third
party testing:
Ccoling Capacity(Btuh): 30000
EER Rating(Cooling): 13.00
SEER Rating(Cooling): 16.00
IEER Rating(Cowling):
Radnor followed w an warrink D makers awlureq--in of prerbusly published dNa,unleas aeverro end with WAS,which inditelacan irnrolumary rerale.
DISCLAIMER
MR,came not ordered the praduM(s)listed an this cMllflcete and makes no representations,warranties or guarantees as to,add dowarms,w mspopun,llly for,
the pmducgs)Intled on this conflicts.AHRI Mpr.N chancellor all liability for damages of any kind arising out of the use or perbrmance of the gadu nel,or the
aulh hund afterelion Of data listed on this eertMcals.certified ratings are vied only for models and configurations listed In the
directory alTERMS www.aM1ritlirectory,arg. a
M13 Car AND CONDITIONS ® V®®
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The Information for Ne11sal clod on tNimber idd the eld.can
wrinedhthe fendrid,an oryaddeclick, en YerllY Certificate-link
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AHRI Certified Reference Number and the dale on which the cedifidate was issued, "I`
which b listed aaeoe,antl the Cardficete No.,which a leafed at bMtam oeM. -------------- ---- ---. ... _- -_,
C0J2014 Alr-Conditioning,Heating,and Refrigeration institute ,CERTIFICATE NO.: 131469437348469912