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HomeMy WebLinkAboutBUILDING PERMIT All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 0' Permit Number: • - Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772)462-1S53 Fax: (772) 462-1S78 Commercial Residential PERMIT APPLICATION FOR: PROPOSED INPROVEMENT`LrOCATION: Address: LI n7� 5 E V e. Ga d CL.. Legal Description: j�JedQ� Property Tax ID#: ��l Q - 2_:30 - C�D4 7 - D 00 y Lot No.4-L Site Plan Name: Block No. Project Name: �bnAe sbn Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: QCern o 1-4 -rZ 1, :S-ee � 44> CONSTRUCTION INFORMATION: Additional work to be performed under this permit-check all that apply: Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _ Electric _ Plumbing Sprinklers _Generator _ Roof Total Sq. Ft of Construction: "?Dq g Sq, Ft. of First Floor: Cost of Construction: $ 5, pC7 Utilities: _Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name Name: Address: L ,,25 5E V LZ( Ck 74y42-, Company: city Lf4 � L��l',L� State: LL Address: Zip Code: Fax: City-�fj,r-}- �- �1.�[',r'� Stater Phone Nob (e 45— q,2R Zip Code:�� :9(rg_ Fax: E-Mail: -- Phone N .—11Z M7 , 4 Fill in fee simple Title Holder on next page ( if different E-Mail: from the Owner listed above) State or County License: l 81 Q if value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: 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 o r Notice of Commencement. G^�� igna� ture,dfowner/Agent/Lessee Signature of Co or/License Holder STATE OF FLORIDA STATE OF FLORID&, �� COUNTY OF (iU� COUNTY OF �ri- The forgging instrument w a knowledged before me The for PPo�''DDg instrument was,ac cnowledged before me thi!�,�-Wday of 20n by this. y"ay of 20n by (Name of pe o acknowledging) (Name of per n cknowledging) (Signature of Notary Public-State of Florida) (Signature of Notary Public-State of4lorida ) Personally Known r✓ OR Produced Identification Personally Known �OR Produced Identification Type of Identification Produced Type of Identification Produced a+P } DEI�RUSSELL Commission o,:= " B'; DEBORAH gam[ L Commission No. o°ayP'' _ Notary Public - State of Florida =r°, ' Commission # FF 179630 Notary Public-State of Florida :N c o'Fo,F S My Comm.Expires Nov 3 ,2018 ;9r FCFF a• My Comm. ExpiresNov 30,2018 REVIEWS VISOR PLANS VEGE TIN" COUNTER REVIEW REVIEW REVIEW REVI R I EVIEW DATE RECEIVED DATE COMPLETED ev. I At &JIM This combination qualifies for a Federal Energy OME MEN CERTIFIED J Efficiency Tax Credit when placed in service www.ahrir . between Feb 17, 2009 and Dec 31, 2016. Certificate of Product Ratings AHRI Certified Reference Number: 8676055 Date: 9/21/2017 Product: Split System: Air-Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: 4A7A6049J1 Indoor Unit Model Number: TEM6AOC42H41+TDR Manufacturer: AMERICAN STANDARD Trade/Brand name: AMERICAN STANDARD 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: SILVER 16 Manufacturer responsible for the rating of this system combination is AMERICAN STANDARD 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): 46000 EER Rating (Cooling): 13.00 SEER Rating (Cooling): 16.00 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.ahrldIrectory.org. TERMS AND CONDITIONS 04 "cap, 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; ■■ -' 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'Verity 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 ©2014 Air-Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 13150471695 477a510 r This combination qualifies for a Federal Energy Efficiency Tax Credit when placed in service A"W"M MRS CERTIFIW�) i directory.or between Feb 17, 2009 and Dec 31, 2016. 5Q Certificate of Product Ratings n AHRI Certified Reference Number: 10056173 Date: 9/21/2017 Product: Variable Speed Mini-Split Heat Pump, with Remote Outdoor Unit Air-Source, Free Delivery Outdoor Unit Model Number: MPB018S4S-1P Indoor Unit Model Number: MWMA018S4-1 P Manufacturer: LENNOX INDUSTRIES, INC. Trade/Brand name: LENNOX Series name: Manufacturer responsible for the rating of this system combination is LENNOX INDUSTRIES, INC. , 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): 18000 EER Rating (Cooling): 13.00 SEER Rating (Cooling): 21.00 Heating Capacity(Btuh) @ 47 F: 18000 Region IV HSPF Rating (Heating): 10.40 Heating Capacity(Btuh) @ 17 F: 11400 I I CERTIFIED RATINGS FOR VARIABLE-SPEED,MINI-AND MULTI-SPLIT SYSTEMS ARE VALID FOR ALL COMBINATIONS OF INDOOR UNITS (BASED ON COMBINATION TYPES)WITH THE SPECIFIC OUTDOOR UNIT LISTED ABOVE AND IN THE AHRI DIRECTORY OF CERTIFIED EQUIPMENT.VISIT WWW.AHRIDIRECTORY.ORG TO VERIFY THAT THIS COMBINATION IS AN ACTIVE LISTING AND THE DATA LISTED ON Tj S CERTI IFI�CAy IS AGC�RATE.SEARCH ON THE AHRI R%FF�RTNCE#TO QUICKLY LRC�F�THI G MBINgTIC;N IN THE DIRECTORY. 1 ungs fol ow by an asterisk( indicate a voluntary rerate of previously pu lis data,unless accompanied wit a A whi i icates an mvo untary rerate. i ° 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.ahridlrectory.org. TERMS AND CONS n This Certificate and its contents are proprietary products of AHRI.This Certificate shall only be used for individual,personal and confidential referencerence p 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 far the model cited on this certificate can be verified at www.ahridirectory.org,click on"Verity 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 ©2014 Air-Conditioning, Heating,and Refrigeration Institute CERTIFICATE NO.: 131504926583544255