HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABL INFO PMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ,
Permit Number:
Building Permit Application
Pdannr'ng and DeveloprnentServices
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 here
PROPOSED INPROVEMENT LO ATION: _
Address: 10 (,t
Legal Description: )-4Z-J&e- lO C?
Property Tax ID #: % I ' �� doe; —
Site Plan Name: Lot No.
/fes
Project Name: Block No.
Setbacks Front_ Back: Ri8ht Side: Left Side:
DETAILED'DESCRIPTION OF WORK:
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CONSTRUCTIONINFORMATION:
Itin or to ,1111, re! orrne un er t is permit c ec a appy;
HVAC Gas Tank E]Gas Piping _ Shutters
Electric 0 Plumbing OSprinklers Generator
Total 5q. Ft of Construction: S . Ft, of First Floor: _
Cost of Construction: $ Utilities: Sewer Septic
OWNER/ ESSEE: CC?NTRACTOR.
Name �C '�'/L��''r Name:
Address _ am.a y: 4i' fl
City: %'1) 'r c ` . � add is, n {
State
Zip Code: Fax:��
City:'
Phone No. % �' �$� + Zip Coder 1
E -Mail: C1 Phone Na— —G-�
Fill in fe imple7itle Holder on next page if differentK1
from the Owner fisted above] -Mail: n ��
State or County License: C
if value of construction is $2500 or more, a RECORDED
Windows/Doors
Roof
Building Height:
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STATE OF FLORIDA
9
COUNTY OF
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DESIGNER/ENGINEER:
` Not Applicable
The for o' g instrur� ent was cknowledge b fore n� .9 - �
this °'ay ff1 Z "/( / `y
MORTGAGE COMPANY:
Not Applicable
Name:
t�
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Name:
REVIEW
_
Address:
Address:
( 1gnature of N tart' Public- State of Florida)
City:
State:
1111i4trrr
City:
Type of Identification Produced
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 representation that is granting a permit will authorize thepermit 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 Jhge first inspection. If you intend to obtain financing, consu n attorney before
or recon inn-y.Qur Notice of Commencemi
Signature of Owner/ Lessee/Agent
r -
STATE OF FLORIDA
9
COUNTY OF
m ,
this! day of `Ire % , 20 Z2 by
a
The for o' g instrur� ent was cknowledge b fore n� .9 - �
this °'ay ff1 Z "/( / `y
of 20
-v
D�P_-
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`rrNiif�li14.
(Name,pf person acknowledging)
ature of Notary Public- State of Florida
Personally Known OR Produced identification
Type of Identification Produced
Commission No.E � (Seal)
Revised 07/15/2014
Signature of Contactor/License
STATE OF FLOR A
COUNTY OF
r-- �'
ZONING
SUPERVISOR
Theforgo,Ag instru ent wasy�cknowledged before
71
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this! day of `Ire % , 20 Z2 by
a
o o�
-v
REVIEW
t�
Ec
ca
(Name of rson acknowledging)A+.�����
REVIEW
DATE
( 1gnature of N tart' Public- State of Florida)
COMPUTE
1111i4trrr
Personally Known L --'OR Produced Identification
Type of Identification Produced
Commission No. �`7� (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPUTE
INITIALS
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 Ratinas
AHRI Certified Reference Number: 10259407 Date: 8/24/2017
Product: Split System: Air -Cooled Condensing Unit, Coil with Blower
Outdoor Unit Model Number: EL16XCi-036-2306**
Indoor Unit Model Number: CBA27UHE-036-230*+TDR
Manufacturer: LENNOX INDUSTRIES, INC.
Trade/Brand name: LENNOX
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: ELITE EL16XC SERIES
Manufacturer responsible for the rating of this system combination is LENNOX INDUSTRIES, INC.
Rated as follows in accordance with AHRI Standard 210/240-2008 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): 34600
EER Rating (Cooling): 13.00
SEER Rating (Cooling): 16.00
IEER Rating (Cooling):
* Ratings foilowed by an asterisk (*) indicate a voluntary cerate 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.ahridlrectory.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 The
reference purposes, contents of this Certificate may not, in whole or in part, be reproduced; copied; disseminated;
AV-imim
entered into a computer database: or otherwise utilized, In any form or manner or by any means, except for the user's individual,
IL
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.ahridirectory.arg, click on "Verify Certificate" link
and enter the AHRI Certified Reference Number and the date on which the certificate was issued,
ive make life better -
which is listed above, and the Certificate No., which is listed at bottom right.
OO 2014 Air -Conditioning, Heating, and Refrigeration Institute
CERTIFICATE ILIO.:
13148068454131711