HomeMy WebLinkAboutBUILDING PERMIT ALL APPLIC !. NFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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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
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Property Tax ID#:
Site Plan Name: IF Lot No.--.
Project Name: Block No.
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Total Sq.Ft of Construction: S .Ft.of First Floor:
Cost of Construction:$ Z O- _ Utilities:Sewer Septic BuildingHeight:ight:
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Phone No. 1'T 2 - q - Z l State: FL
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E-Mail: Phone No.
Fill In fee simple Title Holder on nen't page(if different E-Mail: �� f i
from the Owner lister! above) State or County License:���c��,
If value of construction is$Z50o or more,a RECORDED Notice of Commencenant is required.
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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 our Notice of Commencement.
S
nature of Owner/Lessee/Contractor as Agent for Owner s' store of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF_ `yT U C %a COUNTY OF ST_ LV 1
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 5 day of i � r 20 +j Eby this 4-ItL-day of b 20 0—by
{Name of person acknowledging) {Name of person acknowledging)
ignature of Notary Public-State of Florid IsignZature of Notary Public-State of Florida
Personally Know OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification n Produced
"" SUSAN MONTENE
Commission No. `= te r. MycoggatpN#GG 489499 Commission No. .�';t' °
SUSAM"NEGRQ
EXPIRES:Apri12.20211 fy ' r MY CO&IMISSION#GG 089099
Bonded 1Tn:Notary pu Gc 11nd�v+iars r. X21ri12:2921
, �S�iti•SNk(w ThN Notary Pubbk Under�v[ilers
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
DATE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
COMPLETE
INITIALS
CERTIFIED
Certificate of Product Ratings
AHRI Certified Reference Number:7932229 Date:9118/2017
Product:Split System:Air-Cooled Condensing Unit,Coil with Blower
Outdoor Unit Model Number:4TTR4031Ll
Manufacturer.TRANE
Indoor Unit Model Number:TMM5AOB34M21SAA
Manufacturer:TRANS
Trade/Brand name:TRANS
Region.All(AK,AL,AR,AZ,CA,CO,CT,DC,DE,EL,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:XR14
Manufacturer responsible for the rating of this system combination is TRANE
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): 29000
EER Rating(Cooling): 12.50
SEER Rating(Goofing): 15.50
IEER Rating(Cooling):
Ratings followed by an aslerlsk I'7 indicate a voluntary relate of previously published data,unless accompanied with a WAS,which indicator an involuntary rerale.
DISCLAIMER
AHRI does not endorse We product(s)listed on this Certificate and makes no representations,wafranties or guarantees as to,and assumes no responsibility for,
the product(s)listed on this Certificate.AHRI e%prn_ssly disclaims all fiabAty for damages of any kind arising out of the use or performance at the pmtluct(s),or the
unauthorized alteration of data fisted on this Certificate.Certified ratings are valid only for models and configurations listed In the
directory at www.ahrii irectory.otg.
TENNIS AND 60NoiT1oN5
This Certificate and its contents are proprietary products of AHRI.This Certificate shall only be used for indtwidual,personal and
contidenbat reference purposes.The contents of this Certificate may not,in whole or In part,be reproduced;copied;disseminated;
entered Into a computer database;of Otherwise utilized,in any form or manner or by any means.,emetrt for khn users Intlivitlual,
personal and confidential reference. AIR-CONDITIONING,HEATING„
CERTIFICATE VERIFICATION &AGR1OERATRON INSTITWE
The information far the model cited on this cerlifinate can be verified at--hridireetory.org,click on"Verify Curniticate-Hour i,c�i,,ow.f lc locacr°`
and enter the AHRI Certiraed Reference Number and the date on which the certificate was issued,
Which Is listed above,and the Certificate No.,which is listed at Wrath right. - -------
V2014 Air-Conditioning,Heating,and Refrigeration Institute ° GEfiTIFICA�E NU.: 1 3 1 5021 3545271W85