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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: CL3C3Nil- CA itTY" . r.1FAI . LM ion Planning and pevelopment Services Building and Code Regulation [Division 2300 Virginia Avenue, Fort Pierce Ft 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: - Legal - 11 i / I M06 rI! 0 l' Property Tax ID #: g- (ROV 005R-ODO-1 Lot No Site Plan Name: Project Name: Setbacks Front Back: DETAILED DESCRIPTION OF WORK: Right Side: Left Side: Block No. CONSTRUCTION INFORMATION: Additional work to be pe j Orme un er this permit- c ec a appy: LJ HVAC �I Gas Tarsic El Piping _ Shutters Winrvws t3oors [j [—] / Electric © Plumbing Sprinklers E Generator 0 Roof Roof pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ A_ �C7 Utilities: 0Sewer QSeptic Building Height:. OWNER/LESSEE- CONTRACTOR: Name Name: lN Company: '(� Address: to b 40 Address City:CA r mf A State: Zip Code: 4�D, �5�z Fax:——a. 1� M1- Phone No. '� `�? d a City:,IXC �, _ zip Code: �. Fa : P Phone No.f n% L' ,try ILP up State: -1 _TWf 4445 E -Mail: t13!' Fill in fee simple Title Holder on next page (if different from the Owner listed above) E -Mail: l �� •^ State or County License: C �� vacua vi wIMFULEion rs ,?4DUU or more, a 11MUKOW Notice of commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAIN 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 your Notice of Commencement. Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA , STATE OF FLO A COUNTY OF r . Liv— ty— COUNTY OF 0- . The for Ding instrument was acknowledged before me The for ging instr[� went was acknowledged before me tl i — ay of LI.R 20—Aby this I 67il-ay ofJ 201fl by Name of person making statement Personally Known S OR Produced identification Type of Identification Produced (Signature of Notary p Commission DONNA M. HILL C0 0 f N # GG 099038 EXPj ES: P6130, 2021 Bonded Thru Notary Public Underwriters REVIEWS FRONTZONING COUNTER REVIEW DATE RECEIVED DATE COMPLETED Rev. 8/2/17 Name of person making statement Personally Known X.__ OR Produced Identification Type of Identification Produced (Signature of Notary Publi DONNA M. HILL Commission N - My SION # GG 099038 •,.',EOF �'o„•,•: April 30, 2021 Bonded Thru Notary Public Undenwitere SUPERVISORPLANS VEGETATION SEA TURTLE I MANGROVE REVIEW REVIEW REVIEW REVIEW REVIEW Certificate of Product Ratinas AHRI Certified Reference Number: 7783698 Date: 01-19-2018 Model Status: Active Old AHRI Reference Number Product : Water -to -Air and Brine -to -Air Model Number : TCHN030A*W/K Manufacturer Name : CLIMATE MASTER, INC. Brand Name : TRANQUILITY 16 Rated as follows in accordance with ANSIIAHRIIASHARE ISO Standard 13256-1 Water-toAir and Brine -To -Air Heat Pumps and subject to verification of rating accuracy by AHRI-sponsored, independent third party testing: Full Load PartLoadl Air Flow Rate - Cooling: 1000 Air Flow Rate - Heating: 1000 WLHP (Water -Loop Heat Pumps) Cooling Capacity (Btuh) 28300 Cooling EER Rating (Btuh/watt) 14.30 Cooling Fluid Flow Rate (gpm) 8.00 Heating Capacity (Btuh) 35800 Heating Cop (watt/watt) 4.80 Heating Fluid Flow Rate (gpm) 8.00 GWHP (Ground Water -Heat Pumps) Cooling Capacity (Btuh) 32400 Cooling EER Rating (Btuh/Watt) 22.00 Cooling Fluid Flow Rate (gpm) 8.00 Heating Capacity (Btuh) 30000 Heating COP (wattlwatt) 4.40 Heating Fluid Flow Rate (gpm) 8.00 GLHP (Ground -Loop Heat Pumps) Cooling Capacity (Btuh) 29300 Cooling EER Rating (Btuh/Watt) 16.50 Cooling Fluid Flow Rate (gpm) 8.00 Heating Capacity (Btuh) 23600 Heating COP (watUwatt) 3.70 Heating Fluid Flow Rate (gpm) 8.00 Indoor Blower Motor Fan Type : ECM Sold In? : USA, Canada Part Load2 Part Load3 "Active" Model Status are those that an AHRI Certification Program Participant is currently producing AND selling or offering for sale; OR new models that are being marketed but are not yet being produced."Production Stopped" Model Status are those that an AHRI Certification Program Participant is no longer producing BUT is still selling or offering for sale. Ratings that are accompanied U WAS indicate an involuntary re -rate. The new published rating is shown along with the orev€ous (i.e- WAS),ratina 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 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 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. e@2018Air-Conditioning, Heating, and Refrigeration Institute CERTIFICATE N4.: 131608465064798106