HomeMy WebLinkAboutBUILDING PERMIT ALL APPLit LE NFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: L7 Permit Number:
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)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
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Address: LQ�OAS -,wt C e �eaJ
Legal Description:_ Sr7 0,n1 SV) L0.ki'S Eb i y y J M S
Property Tax ID fl: 130 4 - �l\- l7U O \- 000 - (U Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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Additional woric to on�a rme under s perm -c e k a apply:
WHVAC 13GasTank ❑Gas Piping In_Shutters ❑Windows/Doors
11 Electric Q Plumbing ❑Sprinklers 11 Generator �Roof Roof pitch
Total Sq.Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ 3 3i)O ,00 Utilities:0 Sewer USeptic Building Height:
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Name nO y Name:
Address: B any: (r tT X ►C5'-ki coaffix l =A hrlY
City; f Ct° State:_ Address: hytl N 11c (}►nN t
Zip Code:340161 Fax: City: �-} t'Y State: k=1_
Phone No. l`I 2 -Z[{Z -IR S 1 l o Zip Code:3LA!3 4 11 Fax: -17'7 -y tB\ - g-1 ZZ
E-Mali: Phone No.]72- LA to 1- 6-t t►
Fill in fee simple Title Holder on next page(if different E-Mail: (1r On I.,1 r G10d_
from the Owner listed above) State or County License:-Z.&nu!\10-1 \
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 TITLEHOLDER: 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 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 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
commencingwork or recordin our Notice of Commencement.
"ture of Owner/Lessee/Contractor as Agent for Owner Si ure of Contractor/License Holder
STATE OF COUNTYOFORIDA STATE OF SC- I.ULlEL COUNTY OFORIDAS„_ L_UCA
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this If day of AlAn I 1 20 j?by thisidayof AiAQtACf 20 _aby
J MAE& r_ F C�R 11'�tiFS
(Name of ppyer^son acknowledging) (Name of person'acknowledging)
hLq-)Er— 0
(Signature of Notary Public-State of Florida) (Signature of Notary Public- tate of Florida I
Personally Known OR Produced Identification Personally Known_�?< OR Produced Identification
Type of Identificat Type of Identificatio
t'�N�y CHRIS EPPER M'°ti','k CHRISTINEGULPEPPER
Commission No. COMM M G0081780 Commission No. '• 1: MYCOMMI46WI=GG061780
+ EXPIRES:Jwwmy 1,2021 t EXPIRES:January11,2021
'm Wded TAN Notary PLd&Undwflkls
Revised 07/15/2014
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
FF
I between Feb 17,2009 and Dec 31,2016.rtificate of Product Ratings
Certified Reference Number:8676081 Date:8/1/2017
ct:Split System:AirZooled Condensing Unit,Coil with Blower
or Unit Model Number:4TTR6049Jfr Unit Model Number:TEM4AOC48S41+TDR
facturer:TRANE/Brand name:TRANEn:All(AK,AL,AR,AZ,CA,CO,CT,DC,DE,FL,GA,HI,ID,IL,IA,IN,KS,KY,LA,MA,MO,ME,
N,MO,MS,MT,NC,ND,NE,NH,NJ,NM,NV,NY,OH,OK,OR,PA,RI,SC,SD,TN,TX,
A,VT,WA,VJV,WI,WY,U.S.Territories)
on Note:Central air conditioners manufactured prior to January 1,2015,are eligible to be
lled in all regions until June 30,2016. Beginning July 1,2016,central air conditioners
nly be installed in region(s)for which they meet the regional efficiency requirement.
s name:XR16
Manufacturer responsible for the rating of this system combination is TRArNyE
and
Heat Rated as
Equipment a dsnce ub'suth bject to verrificRI ation of ratingdard 4accuracy-2008 rby AHRI AHRI-sponsored,independent third Air-Source
party testing: I
Cooling Capacity(Btuh): 46500
EER Rating(Cooling): 13.50
SEER Rating(Cooling): 16.00
IEER Rating(Cooling):
'Ratings loMmad 4 anninnink r)IMitpko W,R2la al prknoudy puWhahed seat,VWxy a Vnga,Aetl with.WAS.w otheans an ionstaiRry male,
DISCLAIMER
ANRI dooa not+Morse in-m cheat)lelt0 on this GurtMcelo and AaAM ne MrM6anC1tlons WRryannis or Cuorunlaes as to,and auumes he rxpna1b111tY on.
the preotons)Ilcled on Inls Cetll ord,AHRI awant,OlsGalms eI111nblllly for damages M any Find arising—t of the use no performance of the Weaurt(s,or the
oed,edeed oneralmn or it.,.IW fl on this DeA imta.Cartifled ratings art va1M nniy ton Inodeb and c.efg.atlons listed in Ina
mmetaryaf w,vev,ehridrreecory rag.
TERMS AND CONDITIONS limp,
This Cerrylcale and Its wntenb mC oroedeary vretlucts of AHRI,This CeNNicate shall an],ne used to,hsWidu il,pentanal entl
wnlltlanner reference puryoses,The wntentsef thisCe,tlficato may not In whale or in ARM be feprodulRO;enpled:deuransted; .fir ■■-
ant ad'.toacompnler dalab.n.;or ninniis..011ted In eWformanTanya,or by any mean;eecepl for too.sera lndirkA.1, saw
pe5anal and conddentlo1,e10reMe. ➢1n.11DITICNINW.HPpiIHD.
CERTIFICATE VERIFICATION &REFRIGERATION INSTME
no lnfMmaden far the modso alle,l on Off,Certnha(e Can be verified at wWW.Tnra(Inc[a,y.aB•sheik on•W,iry Certi(vC.'ank _
and to,The AHRI Certified Reference Number and the data 00 Anion the Courca(e was WUN, u•"
whkh fe kned above,and In.CediRcate No,.wraith is llsrant,hafeen,Igh,
02014 AirConditfoning,Heating,and Refrigeration Institute ! CERTIFICATE NO.: 1314609699972'19731