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HomeMy WebLinkAboutBUJILDING PERMIT APPLICATIONALL 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: % 1(f� K�, t l) ,H Y'r r1YlC 1('� 1 r, r1 n Property Tax ID #: L `U7 �j '�(�� - 01)7 - 000-q Lot No._ Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: AWW��W ��� � enc ySb CONSTRUCTION INFORMATION: it ional work to lo—e-Derformed under this permit - check a apply: LLHVAC Gas Tank E]Gas Piping _ Shutters Q Windows/Doors Electric 0 Plumbing Sprinklers Generator Roof Roof pitch Total Sq. Ft of Construction:S Ft. of First Floor: Cost of Construction: $ _�� Utilities: _ Sewer Septic Building Height: OWNER/LESSEE: _ CONTRACTOR: Name_ Y -ii G hf:) Name: i Address: f2.1 f YLLJLflk, City:Pc, 1m L -L t- State: (__L_ Company: f Address: Zip Code:_E�LJS',Ci Fax: City: occ Stater_ Phone No!� - �6Lo (O Zip Code: t~ C31 Fax:I Phone No.' :i-��" a�s3- -jL�� E -Mail: Fill in fee simple Title Holder on next page ( if different E -Mail: ()A\ 4 6.n el\CLI'_�l �C A ck-0 � ccvY from the Owner listed above) State or County License: r'Or „ vaUC u, wmuuLuun is ?c:)uu or more, a KtwKutu Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: Not Applicable Name: MORTGAGE COMPANY: Not Applicable Name: Address: Address: City: State: Zip: Phone City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: BONDING COMPANY: _Not Applicable Name: Address: City: Zip: Phone: Address: City: 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. Rev. 8/2/17 Signature of Owner/ es e/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument wa acknowledged before me this -".day of T 20�_J by this day d��'C,L> > 20 by "u_ -kA 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 oduc d Prlow J (Signature of Notary (Signature of Nota Notary Public State of Florida Sr y� °t� Notary PuGic State of Florida �' • le 1 Commission No. N�lommihsion'6 130604 Commission No. ;� Noelle Sn ral� Expires 08/01/2021 014 y Ces 08/0 12 2 130604 M1 Expires 08/01 /2021 .r'\M REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 8/2/17 ERTI FIE," www.ahri(iirectory.org certificate of Product Ratings AHRI Certified Reference Number: 8242081 Date: 8/29/2017 Product: Split System: Air-Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: GSX160421 F* Indoor Unit Model Number: ASPT59C14A* 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, Hl, 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 of this system combination is GOODMAN MANUFACTURING CO., LP. 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): 40000 EER Rating (Cooling): 12.50 SEER Rating (Cooling): 15.00 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 of AHRI. This Certificate shall only be for individual, and proprietary products used personal 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.ahridirectory.org. click on "Verify Certificate" link „.,,, t;e hie txauer 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. 131484921858357861 ©2014 Air-Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: