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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: 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 IMPROVEJV.IgNT LOCATION: Address. I I� �f Ci 3�1 qu Legal Description: FENS Co�E—UN1T 1-81-K 2-1 Lor c (OK 379SSj g 3q _0_q 01 Property Tax ID #: �L{ —�ba 'OHO cs ,q Lot No. Site Plan Name: Project Name: Block No. P �fl rOS�-- Setbacks Front Back: Right Side: Left Side: DETAILED;DES CRIPTION OF WORK: i, Cr 1 0-n °�e- w -t_ i� r Cv n cLl (-i a,1'" -� o c-'� 3 T4 ►.) (i �2e� ©KuJ e.'il z c -(-C C -fie � 'S+�c Ps , CONSTRUCTION INFORMATION: CREj�rtiona wor to e er orme un er t is permit — c ec a app y: L�IHVAC Gas Tank F]Gas Piping Electric Plumbing Shut ters ❑Windows/Doors Sprinklers Generator Roof Roof pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ Utilities: Sewer Septic Building Height: OWNER/LESSEE::Mul at. CONTRACTOR: Name P-- ,nroS_e_ Address: % l3 avae-rt (�hl/S4lij5,i _ Name: 'p,��.ri�,r coi 6- -T City: V�-, �'f�iC-2 State: YL Com an �� p y C �' — \j c.,2 (_t d, Zip Code: 34 9q Cl Fax: Address: Phone No, Q14 g - (00 -- ay I a Cit y: �b-f T� S� , �� � v o� State: � �-- Zi Code: p Z qa� Fax: -�i3�1-35 i E Mail: 7�a► Fill in fee simple Title Holder on next page ( if different Phone No. I-7 a -(� -2 1 -Isco E -Mail: EC 6-0'f 7A,C. S`'ru I C12- (D- from the Owner listed above) _v .��i L State or County License: _0�oq U_ l If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. DESIGNER/ENGINEER: _ Not Applicable Name: Address: City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: Address: City: Zip: Phone: MORTGAGE COMPANY: _ Not Applicable Name: Address: City: State: Zip: Phone: BONDING COMPANY: Not Applicable Name: _ Address: City:_ Zip: I certify that no work or installation has commenced prior to the issuance of a permit. Phone: St. Lucie County makes no representation that is granting a permit will authorize thepermit 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 commencin qr record irgyo4r Notice of Commencement------ _ Signature of Owner/ Lessee/Agent nature Il STATE COUNTOYOFORIDApy +r ����1� COUNTSTATE OYOFORIDA� t- 5 r The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this,�l day of_ fJ0U�_Y11 20 Lby thisgl day of W\Je/M6en , 20 1'9 by y4LJ�'�- -ek (Nameof person acknowledging) (Name of person acknowledging ) --- - (Signature of Notary Public- State of Florida ) Personally Known '� OR Produced Identification Type of Identification Produced of Notary Public- State of Florida ) Personally Known 1/ OR Produced Identification Type of Identification Produced Commission No. *1 ... t INI"ARIE BOUCHAR Commission No. MY COMMISSION #FF125526 Revised 07/15/2014 (407) 398.0153 1107) 398-0153 1NDA MA&IJbUCHARD MY COMMISSION #FF125528 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS This combination qualifies for a Federal Energy o Efficiency Tax Credit when placed in service CERTIFIED between Feb 17, 2009 and Dec 31, 2016. Certificate of Product Ratings AHRI Certified Reference Number: 8627033 Date: 11/20/2017 Product: Split System: Air -Cooled Condensing Unit, Coil with Blower Outdoor Unit Model Number: 4A7A6036J1 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, H1, 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): 35000 EER Rating (Cooling): 14.50 SEER Rating (Cooling): 17.00 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.ahridirectory.org. TERMS AND CONDITIONS This Certificate and its contents are proprietary products of AHRI. This Certificate shall only be used for individual, personal and AM 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.ahrid irectory.org, click on "Verify 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. � 131556860441329528 CERTIFICATE NO ©2014 Air -Conditioning, Heating, and Refrigeration Institute