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HomeMy WebLinkAboutbuilding permit ALL APPLIC LE NFO MUST BE COMPLETED FOR APPLICATIOl1I TO BE ACCEPTED Date; M 11 Permit Number: i ••u 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 y, fe F I it ;At S-MIRM191.MI .R # ' +t� l ? Af, "�Y ESE Address: Address. t Legal Description: t0 T Property Tax ID#: kL© - _ _ 2- Site Plan Name: Lot N°f--�—s No. l 1 Project Name: Block Setbacks Front. Back: �^Right Side: Left Side: M. 't"r r M s-t calk c, o -f6 Y1 . ,. k Z - 5 "fib .... �/c, isA(IdItI h � Ona WOr e ornte un er sperm —c ecc a app V. 11IMVAC Gas Tank ❑Gas Pi in P g Shutters �Windows/Doors Electric 0 Plumbing' Sprinklers Generator Roof � Roof pitch Total Sq.Ft of Construction: S ,Ft,of First Floor: r Septic Building Cost of Construction:$.__ Z _ t3 0 UtilitiesSewe ` �" g Height: ' + h�l +} V! .r+ 7 iS+S+ ry+yl+ f iti 4r' Nar6e Address:�,Q_LQ Q Z _C 1 C m Name: City: C pang r5 State:EL Address: ' Zip Code: Fax: City: ' Phone No. -t 2 -'�3 Z- 2- 5 � State:F=1_.. Zip Code: y Fax::12-y Lot, 2 E-Mail: Phone No. � - Fill in fee simple Title Molder on nei4t page(if different Phone q-I from the Owner listed above) State or County License. RI/, If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. -SUPPLEMENTAL CQNS 'RU�1'IaN t,IN �.!AYY yf1YQfY1%iTI� V7 tSl �i yf 3 Y s DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: x Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x 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 commencing work or recording amour Notice of Commencement. s �ffn of Owner/Lessee/Contractor as Agent for Owner S ature of contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF S-t _ +,7 >= COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this day of P n „ Y1�7 eY• 20 ,_aby this J�L day of P Yin!p ° 2a _Ll_by 9 1 GW_1 t icS M F P 1tti'+,Es (Name of person acknowledging) (Name of person acknowledging) ignature of Notary Public-State of Florid ) Signature of Notary Public-State of Florida Personally Know �OR Produced Identification Personally Known oR Produced Identification Type of Identification rarh Type of Identif!ca ot� n Produced " susAN MONTENEGRO Commission No. t MYGOI�(!$f" #GGl?89o49 Commission No. k. EXPIRES:Apd 2.2021 SUSAN NfiGRt7 a p, ,�13stdenvtit9rs t�' SAY COMMISSION#GG U89a99 '••sF Ps ft�. 7V'wf.'��.wr'7 ram, r; r. April l2021 7 t\:' 9Ande�i Thru Notary Public UndawflLrs Revised 07/15/241.4 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE 6ArE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW COMPLETE INITIALS This combination qualifies for a Federal Energy Efficiency Tax Credit when placed in service smad CERTIFIED between Feb 17,2009 and Dec 31,2016. Certificate of Product Ratings AHRI Certified Reference Number:8626671 late:9/18/2017 Product:Split System:Air-Cooled Condensing Unit,Coil with Blower Outdoor Unit Model Number:4TTR6030J1 Indoor Unit Model Number:TEM6AQC36H31+TDR Manufacturer:TRANS Trade/Brand name:TRANS Region:All(AK,AL,AR,AZ,CA,CO,CT,DC,DE,FL,GA,HE,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,Rl,SC,$D,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:XR16 Manufacturer responsible for the rating of this system combination is TRANE 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): 29600 EER stating(Cooling): 14.50 SEER Rating(Cooling): 17.00 IEER Rating(Cooling): Ratings followed by an asterisk i"i Indcal.a voluntary mrate of IlMviously publisheo data,unless accompanied with a wAs,which indicates an involuntary rarate. DISCLAIMER AHRI does nut endorse the praduct(s)listed on this Certificate and makes no representations,warramius Or gtiatantees as to.and assumes no responsibility for, the product(s)listed on this Certincate.ANRI expressly disclaims all liiablltty for damages of any kind arising outof the use or performance of the products),or the y unauiharized oralteration of data listed on this Certificate.Certified ratings are valid Daly for models and configurations listed in the tlko=y at--abridireot ,org. MIMS AND CONDITIONS 2This Certificate and its contents are nromietary products of AHRI.This Certificate sflall only be used for individual,personal and A MOP confidenrial rot entm purposes The contents of this Cerllncate may not,In whole ar In part,be rep-c heed:coplod:disseminated; -�� entered into a c mpnier database,or otherwise utilized,in any form or manner'at by any means,except for the uses s individual, personal and confidential reference. A1R-CONOITIONINO.HEATING, CERTIFICATE VERIFICATION 4 REFRIGERATION INSTITUTE The information for the model cited on this certificate can be veined at ww—hridirectory.nrg,click on-Verify Qerttftcate'link �t,.ntaE:c 9ilc betrcr"and enter the ARRI Certified Reference Number and the date an which the certificate was issued, which Is listed above,and the CertMeate No.,which Is listed at bottom right. —----- (WOU Air-Conditioning,Heating,and Refrigeration institute C R CICATE NO.: 131502060542656619