Loading...
HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED )�J Date: �` /�L' Permit Number: I roT Building Permit Application Planning and Development Services AUG 15 2017 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 PROPOSED IMPROVEMENT LOCATION, Address: ®3 S '©Csza YZ 3Y45 Legal Description: Property Tax ID#: n 0` 1 Lot No. Site Plan Name: Block No. Project Name: Ul - ' k.V1.S zPA t Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION,OF WORK wq�jt(41,� Jasllf NPS© Q!&K CONSTRUCTION ]N FORMATION: Addition I 'or to be nertormed under this permit—check all appy: } HVAC Gas Tank ❑Gas Piping _Shutters a Windows/Doors DElectric ❑Plumbing OSprinklers 0 Generator E]Roof Roof pitch Total Sq. Ft of Construction: S . Ft.of First Floor: Cost of Construction:$� � Utilities: _Sewer Septic Building Height: WNER/LESSEE:. CONTRACTOR: Name Z.ans nS Name: Q5 Qr. Address: � �. y, Com an 5 P Y� City: Stater 'Addre s: Zip Code: �� Fax: City: S State: Phone No. Qr Zip Code:�` �-�3- Fax:AM E-Mail: Phone No. `i ll Fill in fee simple Title Holder on next page(if different E-Mail:`(` \ lr S from the Owner listed above) State or County License: LA 511\O If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SU,PL--EMENTAL CQNSTRUCTI.ON LIEN LAIN INFO`RIVIATION 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: OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated. 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 commencing work or recording our Notice of Commencement. " �S': Signature of Owner/Lessee/Contractor as Agent for wrtgr Signature of Contractor/License Holder _m , �m � W nQ C W rn IT STATE OF FLORIDA . =,�N STATE OF FLORIDA COUNTY OF °_ COUNTY OF =z 2 ix�'5ZMco z `�U' c The for oin instru nt was acknowled ed before �L e The forLU this�oing instru t was acknowledged before --W z g g g eE dayof 20j7 by iia this d yo 1,t Ls 20 by <}W ¢>w s //nJ' JJ) m t by.. Name of person making statement ;a°••'•��� Name of person making statement Personally Known OR Produced ldentificati Personally Known OR Produced Identificati -o ` Type of Identification, r ;, „s;r'.\' Type of Identifi ion Producedc�• 1� ' �/ '(� Produced (Signature otary'Public State of Flori a 61 (Signature of Notarylic-State of Florida) Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW - REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.8/2/17 ® o This combination qualifies for a Federal Energy ® Efficiency Tax Credit when placed in service between Feb 17,2009 and Dec 31,2016. Certificate of Product Ra AHRI Certified Reference Number: 5756173 Date: 8/9/2017 Product: Split System:Air-Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: GSX160301 F* Indoor Unit Model Number:ASPT30C14A* 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: GSX16 Manufacturer,responsible for the rating ofithis,system combination is GOODMAN MANUFACTURING CO., LP. L 'JRated as follows in-accordance'with AHRI Standard 210/240-200&for;Unitary Air-Conditloning and Air-Source Heat?ump Equipment and subject to,-ve-rification of rating accuracy by AHRI-sponsored, independent,Ahird party testing Cooking Capacity(Btuh): 27600 EER Rating (Cooling): 13.00 SEER-Rating (Cooling): - 16.00 IEER 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 product(s)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 of the product(s),or the unauthorized alteration of data listed on this Certificate.Certified ratings are valid only for models and configurations listed in 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-CONDITIONING,HEATING, CERTIFICATE VERIFICATION &REFRIGERATION INSTITUTE The information for the model cited on this certificate can be verified at www.ahridlrectory.org,click on"Verify Certificate"link we make fife better" and enter the AHRI Certified 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 ©2014 Air-Conditioning,Heating,and Refrigeration Institute NO.: 131467563x33385160 [�RLTIFICATE