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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: p rrwr 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: 32-264Peric4rine_ FQ�no rte-}- St 1_A le . E L 34gf52 _. Legal Description: P Ai rw `IBCA+ CAV A Y\nQ C,1 LA -b re OiQt 00-1 (PR 5:1 - LAQ) 611 to -1 I()+ loQr 25 CI Property Tax ID #: Lot No.�__ Site Plan Name: _ Block No. !2 _ Project Name: (t2A 1 A _ Setbacks Front Back: — Right Side: Left Side: — DETAILED DESCRIPTION OF WORK, _,AY e_ h a 0 LC ONSTRUCTION INFORMATION: Add itiona wo�Te e�ME d� ncTei tFiis permit - c ec c a app y: F]Gas Q HVAC Gas Tank Piping _Shutters Windows/Doors ❑Electric 0 Plumbing Sprinklers 0 Generator F]Roof Roof pitch Total Sq. Ft of Construction: S Ft. of First Floor: Cost of Construction: $ �� _ Utilities: Sewer Septic Building Height: OWNER/LESSEE: C I � TO ° e� F.... - Name i'�Q 1 0, DCLn1e_1 R Name: 12-(.�I t-*-%�V\fJ'X tr r e -n Address: 3'9- leer lQY I CA C n DY Company: A% (')V\( AC'_ k- k-4Pa 'r1 City: Pnr--t- St e- Luc State: FL. Address: 9n__N EE D i Ate H w v- A 110 D Zip Code: 2,, L4CJ5' 2 Fax: City: _,_ films(21, V + State:LL Phone No. -112- ?j23 12-C) Zip Code:22tLQGIL4 Fax: E -Mail: Phone No. D-12 - -1 I - 2I E -Mail: Qi r P 1 O DI oS ' I Fill in fee simple Title Holder on next page ( if different from the Owner listed above) State or County License: C_AE 1 1-1 g_30 If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. DESIGNER/ENGINEER: Name:_ Address: City: Zip: Ph FEE SIMPLE TITLE HOLDE Name: Address: City: Zip: Phone: Not Applicable State: Not Applicable MORTGAGE COMPANY: Name: Address: City: Zip: ne: ING COMPANY: Name:_ Address: city:_ Phone: Not Applicable State: Not Applicable OWNER/ CONTRACTOR IDVIT: Application is hereby made to obtain a per to do the work and installation as indicated. I certify that no work or i allation has commenced prior to the issuance of a permit. St. Lucie County ma s no representation that is granting a permit will authorize the permit holder to build the subject structure which is in confli ith any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such structure. Pleas,6 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 ­nrina Wrkrie nr nornrrlina vniir NotirP of Commencement. Rev. 8/2/17 ' V Signat re o Co ractor/License Holder Signature of O er/ Lessee/Contractor as Agent for Owner STATE OF FLORIDA STATE OF FLORIDA N1 COUNTY OF f`t1�+_Tit•A) COUNTY OF / ►Ili ✓ -In The forgoing instrument was acknowledged before me The for&oing inst �ment was acknowledged before me day 'f 20V7by this day of �Q40'i 12011-1 by this.A.5 of 90 1 4, �►�p r� I��, l �c�✓ r�✓� Namemo� person making statement Name of persop making statement Personally Known ✓` OR Produced Identification Personally Known ✓ OR Produced Identification Type of Identification Type of Identification Produced Produced J n Je A0, t_,� - 0 " 14�� ocn-'06"., (Signature of No ary ublic- State of Florida r— (Signature of Notary Pu bli State of Pftn'rda ) No.F.71�{aI�HRISTINE A J �; �4: CH���INE A JORDA son No. F i a "yCommission ." MY COMMISSION ax FF235578 :. �; MY OMMISSION # FF2355 r� EXPIRES July 31. 2019«��' EXPIRES July 31, 2019 orwlaNu;, •Y $il �'r. • 'Y ervn:ewn• oum REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED - DATE _ COW LETED Rev. 8/2/17 Certificate of Product Ratings AHRI Certified Reference Number: 7501872 Date: 9/25/2017 Product: Single -Package Air -Conditioner, Air -Cooled Model Number: 4TCC4048A1 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 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): 46500 EER Rating (Cooling): 11.50 SEER Rating (Cooling): 14.00 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 tor, 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.ahrid!rectory.org. TERMS AND CONDITIONS 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 "Verify Certificate" link 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.: 131508266642966134