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HomeMy WebLinkAboutbuilding permit All 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: �� PROPOSED INPROVEMENT LOCATION: Address: Legal Description: Property Tax ID#: Lot No. Site Plan Name: Block NO. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: / — — ¢ a- "t CONSTRUCTION INFORMATION: t a wor to epe orme un ert ispermit—c ec �tatap�py: ��� _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Electric _ Plumbing _Sprinklers _Generator _Roof Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ ��(�� . O C-) Utilities: —Sewer _Septic Building Height: OWNER SSEE: CONTRACTOR: Name ' " t5 Name:I 6 Addr s: ( t Company: City: e'12 State:h L Addre s: Zip —Fax:Code: City: T State: Phone No �1Q } Zip Code: 'W2�-' Fax E-Mail: Phone No. a Fill in fee simple Title Holder on next page ( if different E-Mail y4Lr � from the Owner listed above) State o County License: 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 TITLEHOLDER: _ 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 our Notice of Commencement. Signature of Owner Agent/Lessee nature of Contractor/License Holder STATE OF COUNTY OF �� ,/�/IP COUNTSTATE OYOFORID FL � UCIP_ The for oinginstru twas acknowledged before me The for oing ins tr en t was acknowledged efore me this-dayof n 2CJJby this2rdayof 20 t by 61 D Ctiti lS L + Q 1 U (Name of person acknowledging) (Name of person acknowledging) tgna ure of Notary Public-State of Florida) ignature of Notary Public-State of Florida) Personally Known i✓ OR Produced Identification Personally Known "-'OR Produced Identification Type of Identification Produced kAP.O.Udenfification Produced //�� d`°yy Notary Public Slate FIonW (, ��(�1 4e. °4 Notary Public Slate of Fits Commission No1:��� .'P I ero Katherine Caltlero Commi ton NOGIC21 L�/ +� QdOMYtComHm�isaionOGG t7 �{, My Commission GG 79677 o,�dR Ex0ue6012812022 0ile ExprteS ot26/2022 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. Certificate of Product Ratings AHRI Certified Reference Number :7482150 Date:02.11-201a Model Status :Active Old AHRI Reference Number AHRI Type :RCU-A-CB Series :XR14 Outdoor Unit Brand Name :TRANE Outdoor Unit Model Number (Condenser or Single Package) :4TTR406OL1 Indoor Unit Brand Name : Indoor Unit Model Number(Evaporator andlor Air Handler) :'AM4A0C60SS1+TDR Furnace Model Number: 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,NO,NE,NH, NJ,NM,NV,NY,OH,OK,OR,PA,RI,SC,SD,TN,TX,UT,VA,VT,WA,WV,Wr,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. The manufacturer of this TRANE product is responsible for the rating of this system combination. Rated as follows in accordance with the latest edition of ANSI/AHRI 210/240 with Addenda 1 and 2,Performance Rating of Unitary Air-Conditioning &Air-Source Heat Pump Equipment and subject to rating accuracy by AHRI-sponsored,independent,third party testing: Cooling Capacity(A2)-Single or High Stage(95F),bluh :55500 SEER :14.50 EER(A2)-Single or High Stage(95F) :11.70 IEER : t"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 accomDanlad by WAS Indicate an involuntary re-rate. The new published rating is shown alone with the om0ous 11 e.WAS)ralina. DISCLAIMER AHRI does not endorse the products)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 producl(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 Itss contents are proprietary products of AHRI.This Certificate snail 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; fill ■■ -' entered Into a computer database;or otherwise utilized,In any farm 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.ahrldirectory.org,click on'Verlfy Certificate'link ,rc make lilc boner• 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. a162as7ao2asoaTea ©2018Air-Conditioning,Heating,and Refrigeration Institute CERTIFICATE NO.: BUILDING & CODE REGULATION DIVISION 2300 VIRGINIA AVENUE • FORT PIERCE, FL 34982 772-462-1672 FAX 772-462-1148 AUTHORIZATION FORM FOR CREDIT CARD PAYMENT — CONTRACTOR LICENSING TO: St Lucie County RE: Permit # Credit Card Users: 1.5 Surcharge added per transaction. Payments must be received in this department by 4:00 PM for transaction to be processed that day, if not it will be processed the following business day. VISA MASTERCARD DISCOVER Credit Card Number Expiration Date Zip Code 3 digit security code Amount $ + 1.5% surcharge = Business Name: Authorized Signature: Print Name: Phone: ( ) Fax: ( ) Comments: SLCPDSD Revised 4/01/2013 EN