Loading...
HomeMy WebLinkAboutbuilding permit ALL APPLI ABLE NFO 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 fine PROPOSED] LOCATION: Address: 1 Legal Description: Property Tax ID#: l - WO I- 000- C) Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: CONSTRUCTION INFORMATIO �tiona work to Be e111arme un er t is permit-c ec a nr p Y 0HVAC Gas Tank Gas Piping _Shutters Windows/Doors ��.,1 LJ Electric ©Plumbing Sprinklers lo Generator hoof hoof pitch Total Sq. Ft of Construction: S . Ft.of First Floor. Cost of Construction:$_ 15j Utilities: Sewer Septic Building Height: OWNER/LESSEE CONTRACTOR: Name YQ Name: CA-M Address:_Cp(.f �'� lP �_.. C o m p any: City: C -C State: ( Address: ��If � _ c Zip Code: Fax:�� City: �� Stater — Phone No. `l Zip Code: '}- Fax: L u( 415 E-Mail: �,J -IA Phone No. �r f Fill in fee simple Title Holder on next page(if different E-Mail: from the Owner listed above) State or 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 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 our 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 �� � w �� COUNTY OF �Z ` rAu The forgoi g instru e t was acknowledged Pefore me The forgo" g instr nt was acknowledged Pefore me this ay of 20 17 by thiay of 20by Name of person making.statement Name of person making statement Personally Known _OR Produced Identification Personally Known_X OR Produced identification Type of Identification Type of Identification Produced Produced -iU (Signature of Notary ll� (Signature of Notary Publi ��. f70NNAM.HILL ..V: NA M.HILL '"• '. CO N#GG D99D3t3 = My SIQN#GG 099038 eat Commission N �• Commission N r a EXP ES: pill 30,2D21 :April 34,2D21 �''�°t ``' Bonded Thm Notary Public Uinderwiiers ,., ..r Bonded Thru Nntary Public Underwriters REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev,8/2/17 This combination qualifies for a Federal Energy Efficiency tax Credit when r placed in service between Feb 17,2009 and Dec 31, 2016. Certificate of Product Ratings AHRI Certified Reference Number :8703698 Date:02-23-201 a Model Status :Active Old AHRI Reference Number AHRI Type :RCU-A-CB Series :SILVER 16 Outdoor Unit Brand Name :AMERICAN STANDARD Outdoor Unit Model Number (Condenser or Single Package) :4A7A6042J1 Indoor Unit Brand Name : Indoor Unit Model Number(Evaporator and/or Air Handler) :TEM4AOC42S41+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, ND,NE,NH, NJ,NM, NV,NY,OH,OK,OR,PA,Ri,SC,SD,TN,TX,UT,VA,VT,WA,WV,Wl,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 AMERICAN STANDARD 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),btuh :41000 SEER : 16.00 EER(A2)-Single or High Stage(95F) : 13.00 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 setling or offering far sale. Ratings that are acegmPanied by WAS indicate involunta�r rate The new published rating is shown along with the Previous(i.e.WAS ratino. 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.ahrldirectory.org,click on"Verify Certificate"link and enter the AHRI Certified Reference Number and the date on which the certificate was issued, we make life better- which is listed above,and the Certificate No.,which is listed at bottom right. 02018Air-Conditioning, Heating,and Refrigeration Institute CERTIFICATE NO.: 131638719755975470