HomeMy WebLinkAboutBuilding Permit ApplicationMUST BE COMPLETED FOR APPLICATION To BE ACCEPTED
Date:l 11/Eld l 9 Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
1300 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 Ilne nA
I�i ulit F'ir3mxr's x 5a C�tri _
Address:
Legal Description:
Property Tax ID #:
Site Plan Name:
Project Name:
Setbacks Front Back:
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Right Side: Left Side:
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i0 KvJ e leC tyiC_ knit .
1j.Jt1VAC L_( Gas Tank UGas Piping UShutters
Electric 11Plumbing ❑Sprinklers (Generator
Total Sq. Ft of Construction: Sq. Ft, of First Floor: _
Cost of Construction:$ L4190 C� Utilities: Sewer
,�.., _.. Septic
_.-,. . .. X . , ` � State: f _L
Zip Code: 4 q $ 7 Fax:
Phone No. -1 -12- , o - qz�-'--( 2
E -Mail;
Fill in fee simple Title Holder on neg't page I If different
from the Owner listed above)
Is $2500 or more, a RECORDED Notice
Lot No._�
Block No.
n❑ windows/Doors
L iRoof E-1 Roof pitch
Building Height:
Name: �LyIGC a r.+t:
Company.Gsr]imCS hFt'xa�ti innt� j 1
Address:jrj/a N tAC u. N �'
City: F}I CYC -C
Zip Code: 5t -IC -t State: F L
Fax: -im - � t P _$-122
Phone No. l'7�_ y�g1 � 1
E -Mail: YI YVL A C �
State or County Licensee
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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: z 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 ermit will authorize the ermit holder to build the subject structure
which is In conflld with am applicable Home Owners Association rules, bylaws or an covenants that may restrict or prohibit such
structure. Please consult w th your Home Owners Association and review your deed or 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
commenciniz work or recording your Notice of Commencement.
nature of Owner/Lessee/Contractor as Agent for Owner
S ature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF 6T_ L.Ut A'F
COUNTY OF (—_ L-0c I E
The forgoing instrurent was acknowledged before me
thls�A day of N o\/ e Inn 20 J by
The forgoing instrument was acknowledged before me
this LO day of N nV GiMb 20 L -7 by
AFlP ES F l CaMf=s
1rFIVLTIS r C 2.l its
(Name of person acknowledging)
(Name of person acknowledging)
gnature of Notary Public- State of FloriclA )
115ignature of Notary Public- State of Florida
Personally Knowr��OR Produced Identification
Personally Known>5�!�OR Produced Identification
Type of Identification
Type of Identifica iotr n Produced
SUSAN MONTENEGRO
Commission No. My cOA(IA{Ia1jION#GG089099
a ar EXPIRES:A02.20211
Broiled Tnm Noury PUWUadMfft1'aEYPIR
Commission No. :'k'••., SUSAN WMANEGRO
"• t MY COMMISSION NGG089099
-
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'••:�„;7i�`.•�
Revised 07/15/2014 BOWW Thru Notary PUM MWOM
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
LCERTIFIED
Certificate of Product Ratings
AHRI Certified Reference Number: 7944313 Date: 11/14/2017
Product: Split System: Air -Cooled Condensing Unit, Coil with Blower
Outdoor Unit Model Number: 4TTR6061C1
Indoor Unit Model Number: TEM4AOC60S51+TDR
Manufacturer: TRANE
Trada/Brand name: TRANE
Region: All (AK, At, AR, AZ, CA, CO, CT, DC, DE, FL, OA, HI, ID, IL, IA, IN, KS, KY, LA, MA, MD, ME,
MI, MN, MO, MS. MT, NC, NO, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, RI, SC, SO, 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 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): 56500
EER Rating (Cooling): 12.50
SEER Rating (Cooling): 15.00
IEER Rating (Cooling):
NMogs scamiel by an amorket I'I akirohe a Wamt ry rents of pmviciedy pubih,mi sea. uouse ecmu
penietl wIN a WAS, wMtl, i,tltrnlea an Invqunln,y rsa4.
DISCLAIMER
AHRI does not endorse the Assume.) listed on this Certificates and makes red representations. Warmness, or guarantees as to. and Assumes o, empommiliry for,
the pmduct(s) listed on this Command, AHRI expressly disclaims an Ilaiddly for damages of any kind arising our of theme or performance of Na productis), or the
unauthorized ateralian of doL head on this Certificate. CertMotl -iinp ere valid only f , meddler and configurations listed in the
dimctwy at waw.ahAtllmclery.org.
TERMS AND CONDITIONS
This Certogerm and its contents are proprietary producer of AHRL This Certificate shall only he used far Offivimml. personal and As "®®
.caf demist reteranca purposes. The cpntems of this CeDlflrale may not in whole or in part, be reproduced: copied: disseminated; On ILi
entme, Into a compuleromakse: m othemise ennead. In any form or manner or by any moons, except forms users IndMdual,
Personal and confidemkin refar.... AIRLONORMNINa, HEATING.
CERTIFICATE VERIFICATION bREF-dmAA'0N INE➢ME
The Information for me ..ml clUd on this wdlHcale can bo Welnad a[ wwwahr1,14oe1sry.orR. slid an 'Verify Cerllfieote' gas
endarm,me AX reN
Certified Reference Number and the data on which the CertNit9te Was issued, "n"' ""
W
With he""
above, and the Certificate Na. Which lS listed at hMtem NAIL
ID2014 AirEonditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 1315515329092x1067