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HomeMy WebLinkAboutBUILDING PERMIT ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 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 PROPOSED IMPROVEMENT LOCATION: Address: �;-�� C 1-1 RV r 1 Legal Description: ( ���yE� 7P, ,2.Y_- u ►., " ` 1,3 Property Tax ID#: `liq f0 OfCq ` 000- : Lot No. 1 Site Plan Name: Block No. f Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: K U CONSTRUCTION INFORMATION: AdLditi a wor to e e orme under this permit-check a apply: HVAC 11 Gas Tank I Gas Piping _Shutters Q Windows/Doors 11 Electric ❑ Plumbing Sprinklers El Generator E] Roof Roof pitch Total Sq. Ft of Construction: S Ft.of First Floor: Cost of Construction:$ 3 Utilities. _Sewer Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name /'�'3 r�llc�l/ �L/, R nf' Name: _ A r-e: "IA Address: 606 H Ara = Company: (ar. �j /-1 an_ �� t-i .uoi_9 &Z City: PO —— 5-t- Lv r l L State: 'R_ Address: Al rim r.yNf?_ (r Zip Code:�`����Z Fax: City: kuc'/zE: Stater Phone No. , '� ca Zip Code: ":� e-�o �z Fax:`7"7.)- 335' f£e7_ E-Mail: Phone No.�-���- 13--s- fit;/ Fill in fee simple Title Holder on next page(if different E-Mail: ( ,'c-7i' 4V A0i_, r-o/11 from the Owner listed above) State or County License: If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. _.�� ,a•.,.�'.'�:• _. 3'. '. . ud�.,,:�.. C- .n � IW.".0 ._:..M::;,.°�'�'.'�` •:x .•,u »�.::�. s 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. Sig Owner/Lessee/Contractor as Agent for Owner Sig Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF 5 * Luill COUNTY OF l.yat CO-Aii The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this Z_!Sr day of a 20 17 by this Z'S day of 4,jgo 5-r 2l by VA Name of person making statement Name of person making statement Personally Known ✓OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced Si nature of Nota ate o (Signature of Notes 4' Stataso �d WALSH (Signature—of A WALSH t . _.` `= MY COM SI #FF091118 MY COMMIRgv#FF091118 Commission No. '� 'off; aQ� Commission No. = '" `o� F XPIRE �pfil 11,2018 oFr��.•• EXPIRES April 11, 2018 (407),399-0153 FloridallotaryService,com (407)398-0153 Floridallotaryservice.com REVIEWS FRONT . ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.8/2/17 This combination qualifies for a Federal Energy c Efficiency Tax Credit when placed in service Jou9023 CERT Ibetween Feb 17, 2009 and Dec 31, 2016. Certificate of Product Ratings AHRI Certified Reference Number: 8900214 Date: 8/24/2017 Product: Split System: Air-Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: TC7133021 Indoor Unit Model Number: AE30BX21+TXV Manufacturer: CHAMPION BY JOHNSON CONTROLS Trade/Brand name: CHAMPION HEATING AND COOLING 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: LX SERIES Manufacturer responsible for the rating of this system combination is CHAMPION BY JOHNSON CONTROLS 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): 27800 EER Rating (Cooling): 14.00 SEER Rating (Cooling): 17,00 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 in "120 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; rso on ai 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 life 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. 131480661658650429 CERTIFICATE NO.: ©2014 Air-Conditioning, Heating,and Refrigeration Institute