HomeMy WebLinkAboutBUILDING PERMIT ALL.APPLICMLY NPO MUST BE COMPLETED FOR APPLICATION TO BE ACCENTED
Date: Permit Number:
7Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 349r82
Phone: (772)462-1556 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
zG�l0kn+c-0i
• � °; ,S .�'+C y .ti{ ;r�,Y� 1..�• J`� +s !.,r S t� �rt�Y�•�ji��r<Y�Y�ti�"� ; t °�( r 'r :1�':.. :.
Address: R k p\
Legal Description:
Property Tax ID#: I Z o _
Lot No.
Site Plan Name: Block No. —�—
�^
Project Name:.
Setbacks Front_ ,—� Back: Right Side: Left Side:
, � r •� �}.� I �+��� r a�±f � °{� �4F.rl r';{ ! r r t :. 8-
r i i { e4'+i t'�rhISr CIOf:
MW
lYl S)_01ti �� C� 1� T A• �r7' ie. .:.. rr..r• . r.r tir b+
�. �c' ��1G� Z. S Ta f11
w:�� s s�� , , 1 ��� ,�; C )r--kN p e r
• 1. r i � ' S7 I �nr��?lM1e tir1..- r f f •S
171
Otte wor c oR e rmed un er ithis perm —c ec c a a `r
Ap y:
NVAC Gas Tank E]Gas Piping Shutters Q win dows�Doors
Electric Q Plumbing ❑Sprinklers Generator Roof Roof pitch
Total Sq.Ft of Construction: S .Ft,of Furst Floor:
Cost of Construction:$ 2- (;� Utilities:USewer QSeptic Buildin Height:
x g Ea
qqq � � r l, f _ „t•.S t�rf�.rt��, , i 4 7 r {7� j _+5.+`:t'..,
Nam���_•�'y�1 1 4� "9 � ..� + i�.i� r•• ar{f r>`. r � y+i•+r:r{'''
Name:
Address: t5S t.I _ky f�l�} #e h � Company. C .'Y1�PCa-3 N1 F 'e r
Clay: _ State: Z. Address' `
. 5+ N 1JIC u ti .: '�
Zip Bade:�q 4 g,. Fax: City:�'r. '�� �+r,�� •
State:fit_
Phone No. z-l.n 9 2 Zip Code: y Lax
--------------
E-Mail: �?
Phone Na, _ c�—(
Fill in fee simple Title Molder an negt page(if different E-Mail: l
from the Owner listed above) State or County License;
If value of cvnstruGdon Is$2500 or more,a REeORDED Notice of Cntnmencement is required,
ZT
aUPPEI111ENTR .CoNSTRLJCTIN`L�ElU� :P�1lVYINFCIRIVIATI6Nf #°
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.
t�.—�•. --��
s
[4nature of Qwner/Lessee/Contractor as Agent for Owner S' ,ature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 5�-r. L C F_ ___ COUNTY OF_ CT. I .0 c ky-
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of -Q 20 laby this day of Se)p 4,20 __O_by
(Name of person acknowledging) (Name of person acknowledging)
ignature of Notary Public-State of Florid ) Signature of Notary Public-State of Florida
Personally Knowrl�_� OR Produced Identification Personally Know OR Produced Identification
�p ,
Type of Identification GRO Type of Identification Produced
p
iR.:S6k••, i Sl1SAN FhONTENE
Commission No. .{ MYCOA[� GGoi3soss Commission Na. SUSAN �NEGRO
:s;; EXPIRES;April 2,2021 � '� MY COh4M1SSfON#GG o89099
Bonded ThN N0 7 Hoc Ustdatwr3�rs r ill 2.2021
.; 1`: Bonded ThN Mota+y Pubk UrOwwrt srs
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
M
Certificate of Product Ratings
AHRI Certified Reference Number:9193124 Date:9/18/2017
Product:Split System:Air-Cooled Condensing Unit,Coil with Blower
Outdoor Unit Model Number:CA14NA030*0**A*
Indoor Unit Model Number,F84CNP030L.
Manufacturer:CARRIER AIR CONDITIONING
Trade/Brand name:CARRIER AIR CONDITIONING
Region:Southeast and North(AL,AR,OC,DE,FL,GA,HI,KY,LA,MD,MS,NC,OK,SC,TN,TX,VA
AK,CO,CT,ID,IL,IA,IN,KS,MA,ME,Mir MN,MO,MT,NO,NE,NH,NJ,
NY,OH,OR,PA,RI,SD,UT,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:14 SEER AC
Manufacturer responsible for the rating of this system combination is CARRIER AIR CONDITIONING
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): 28600
EER Rating(Cooling): 12,50
SEER Rating(Cooling): 15.00
IEER Rating(Cooling):
Ratings kAlo,ved by an.asterisk(')indieale a valunlary rarateor previously published data,unless acaampanied with a WAS,which indicates an involuntary rerale.
DISCLAIMER
AHRI does not enderse the pmduct(s)listed on this Certificate and makes no representations,warranties or guarantees as to,and assumes no responsibility for,
the prodactts)listed on this Certificate.AHRI expressly disclaims all liability for damages of any kind arising out of the use or performance of the produa(s),or the
unauthorized alteration of data listed on this Certificate.Certified ratings ar.e vaiid only for models and conf,guraticns listed in the
directory at www.ahridireetory.arg.
TERMS AND CONDITIONS in"IMF
This Certificate and its contents are proprietary pr tr oduc of AHRI.This Certificate shalt anfy be used for lntlivldua[,personal and
confidential reference purposes.The contents of this Certificate may not,in whole or In part,be reproduced',copied:m disseminated; . �■��
entered into a computer database;or otherwise Utilized,in arty form or manner or by any means,escapt for the user's individual,
personal and confidential reference. AIR-Comemommc,HEATING..
CERTIFICATE VERIFICATION &REFRIGERATION INSTITUTE
The inforehntion for the model cited on this certificate can be verified at wv w.alhfidirectory,org,click on'Verity Certificate-]ink c.Rhds f h h11rRr'"
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.
02414 Aittorfditioning,Heating,and Reirigeralion institute CERTIFICATE NO.: 131502119289194698