HomeMy WebLinkAboutbuilding permit ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
iw.
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 X —
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PitOPOSEp.I1Vti�itOvC1tINT I OAI IQN;
Address: T /� 3 KV
Legal Description: 41_ramli 9- -4-7- Al 11uTC,uii✓S,9 / 1 AgVA All r &Of 7>V-
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Property Tax ID#: /}L -3 - S [o S—,9 p v_r-DUI -a Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OFWORK:
LA/STALcAT/oil OF(l) S ?on/ G'A2Ki�yL �✓R7EY� Sou2CE f/b T / �hP.
CONSI RUCTION INFO,"id'Jr,N
Adanional work to be erforme un ert ispermit-c ec a appy:
IOHVAC Gas Tank Gas Piping _Shutters ❑Windows/Doors
Electric El Plumbing Sprinklers ❑Generator 0 Roof Roof pitch
Total Sq. Ft of Construction:,, S Ft.of First Floor:
Cost of Construction:$ L'V?a.O c Utilities:0Sewer O Septic Building Height:
PWNWRIL� SE, � CONTRACTOR:
NameNG__LSCo GCO ET Name: -
Address: 4f33o N gyi7-fl;l a Company: ye-
City: y/�z__P/; PG State: /4:2- Address: 30 S Al WS
Zip Code: 3545 �49 Fax: City: %v2E /e_t State:FL
Phone No.SG/ .30l .1p g 3 j Zip Code: y SL(a Fax:
E-Mail: Phone No. )R 7/z
Fill in fee simple Title Holder on next page(if different E-Mail:. �'U.S�.f/Gt/mESAc@,¢c,t euq
from the Owner listed above) State or County License: k4 00/'P p 7/
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: 4Not 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. \��d
Si ture of Owner/lessee/Contractor as Agent for Owner SIg re of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgo��ii1 instrument was acknowledged before me The forgoin instrument was acknowledged before me
this— ay of Ah-n-G .204C%Yby this_7y of 1�I4 s� 20 by
Name of person making statement Name of person making statement
Personally Known�� OR Produced Identification Personally Known A;= OR Produced Identification
Type of Identification Type of Identification
Produced Produced
Signature of Notary Public-State of Flatfda) ignature of Notary Public-State of Flori )
Commission No. "'r'yyr SUSNEGRO Commission No.
MYCOMMISSION#GG099099 +:?::y'• SUSANMONTENEGRO
EXPIRES. ..-12021 "R" �„ MY COMMISSION#GG 089099
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COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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Rev.8/2/17
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Certificate of Product Ratings
AHRI Carstens!Reformulate Number:71US11 Data:05-21-2D18 Model Stands:Discontinued
Old AHRI Reference Number
Product :Womr4o-Air and Bdne4oAif
Modal Number:SOPCWWL/R"3/CA
Manufacturer Name :CARRIERCORPORATION
Brand Name a CARRIER
Rated as follows In accordance RIB,ANSVAHRVASHARE)ISO Standard 13256-1 Waler bokir and BrineJo-Air Heat Pumps and subject to
VeBRcation of offing accuracy by AHRI-sponsored,independent third parry taring:
Full Load Part Loadi Part Load2 Part Load3
At,Flow Rate-Cwwv. 2000
Air Flow Rate-Heating: 2000
Vat(Wabr-Loop Hoe Pumps)
Cooling Capacity(stun) 57900
Cooling EER Rating(BhthAVeti) 1320
Cooling Fluid Flow Ram(gpml 15.00
Heating Capacity(awh) 67200
Heating Cop(watffwaB) 4,20
Heating FWW Flaw Rate(gpm) 15.00
OWHP(Ground Wator-Host Pumps)
Coating Capacity(Stuh)
Goofing EER Rating(Boulf/M fi)
Coating Fluid Flow Rate(gpm)
Healing capacity(etuh)
Heating COP1watl/wetU
Healing Fluid Flow Rate(gpm)
GLHP(Ground Loop Heat Pandas)
Cooling Capaciy(etuh) 5010D
Cooling EER Rafting(MIVWaW 15.00
Cooing Fluid Flow Rate(gpm) 15.00
Heating Capacity(Blob) 469W
Heagg COP(waBAvett) 3.20
Healing Fluid Ft.Rate(gpm) 15.00
Indoor Blowsy Motor Fan Type :PSC
Bola In? :BSA
}Models with-Obwnfinuuo'Model Statue ere Nose Cause AHRI Cartih ulbn Progrem PaNtlpint no longer prWucee AND la no torpor wo ng or oflemg for oak.
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DISCtA1MER
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the Methanol ahead he this CeniflcoN,AHRI erpresdy diwlMmeell II.Why he damages alum kind being out Wthe use IXp rformanw a the pleduGM).Orthe
unauthorized pIwmtlon of den Stood on this Carilawte.channel mhnpt ere volts any for metals and configurations listed in the
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LCERTIFICATE VERIFICATION a REFWGSR1mVN INeprme
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®2(18WFr Conditioning,Heating,and Refrigeration Institute CERTIFICATE NO.: 13188t1ooBbo2oa5oa