HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO M SgT BE COMPLETED FOR APPLICATION TO BE ACCEPTED J )
Date: Permit Number:
R E C I V3 E D
Building Permit Appli ation APR -6 2018
Planning and Development Services
Building and Code Regulation Division Permitting Department
2300 Virginia Avenue,Fort Pierce FL 34982 . St. Lucie Co ty, FL.
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential f
PERMIT APPLICATION FOR:
PROPOSED INPROUEME'IVT LOCATIONisf
.'„ ' k. e .t .?••.a
Address:
Legal Description:
Property Tax ID#: '� �V �— J �� � Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK
s
RUCTIN$
;CONSTOIN -OR IVI`ATION'
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_ .`+,.. ted. �, .3.,,.�y,a r, ..X_, r`,3..,C:� � �..{v'> ; 9,. r•.-.,
7rt�na wor� fto • e performed under t is permit—check a t at appy:
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: Utilities: —Sewer _Septic Building Height:
OWNER SEE „ ' CONTRAC`l"OR �` y
Name A-,)"q ,Q Name: / '5
Addr s: Company:
City: StateYr;�-_ Address: ctrlP—A-4-6s. eo
Zip Code Fax: City ;Y (), _ S`t`ate_2:p-(--
Phone No V/ e3 Zip Code: Fax:��
E-Mail: Phone No. a-
Fill in fee simple Title Holder on next page (if different E-Mail
from the Owner listed above) State or ounty License: C,1 4(jpy
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
I
SUP,PLEl1JiElVTAL CQNSTl�UCTlON' Ll#EN LAW ENFQRMATr!£QN
.
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 Twill,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.
S ure of Owner/Agent/Lessee Signature of Contractor/License Holder
STATE OF FLORIDA, t STATE OF FLORIDA
COUNTY OF fit' .�, COUNTY OF
The f going instru n�t�-w�,a's acknowledged before me The forgoing instrume t was acknowledged b_gfare me
this�day of 20'W' by this day of �_,20_L�$y
On Lqe"�'o On.I dcv-0
(Name of person acknowledging) (Name of person acknowledging)
Signature of Notary Public-State of Florida} (Signature of Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Known �,/—OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission N� �— �� � Y A ^ Nota y Public'Sta e�C#t�j S51 NO� � �Q��� I/ Notary Puotic State or rias
KaMenne Caia ro Kail7erine Calriero
My COMM,satoll G 179677 " r MY Comm Heron GG t1 77
u.rip EX01res r
rn
REVIEWS FRONT ZONING SUPERVISOR f3S� VEGETATION SEA TURT
COUNTER REVIEW REVIEW- REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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er ificafe of ProauctRatings
AHRI Certified Reference Number:7482150 — Date:04-06-2018 Model Status:Active
AHRI Type:RCU-A-CB
Series:XR14
Outdoor Unit Brand Name:TRANE
Outdoor Unit,Model Number (Condenser or Single Package):4TTR406OLl
indoor Unit Model Number(Evaporator andfor Air Handler):'AM4A0C60S51+TDR
Region:• All(AK,AL,AR,AZ,CA,CO,CT,DC,DE,FL,GA,HI,ID,IL,IA,IN,KS,KY,IA,MA,MD,ME,MI,MN,MO,MS,
MT,NO,ND,NE,NH,NJ,NM,NV,NY,OH,OK,OR,PA,RI,SC,SD,TN,TX,UT,VA,VT,WA,VW,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.
The manufacturer of this TRANE`product is responsible.for the rating of3his system combination.
Rated as foll6vis,in accordance with the latest edition of ANSIIAHRI 210/240 with-Addenda i and 2,Perforntance Rating of-Unitary
Air-Conditioning,&Air-Sou rce:Heat;Ptimp Equipment„and;subject to rating.accuracy by`AHRi-sponsored„iridependent,third party-testing:
Cooling Capacity(A2)-,Single or High Stage(9517),btuh 55500
SEER:14.50
EER(A2)-S1ng1e ot:High Stage(95F) :11.70 ;
t"Active`Model Status are those that an AHRi Certification Program Participant is currently producing AND selling or offering for sato;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 tale,
ati s that aree jacco anied by WAS indicate an involunta re-rale The new published ratinh is shown along with[tie previous(!,a,WAS rating
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),br the
unauthorized alteration of data listed on this Certificate.Certified ratings are valid only for models and configurations listed in the
directory at tvww.ahrldfrectory.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 computerdetabase;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 t,Frake tib henry
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.
02018Air-Conditioning,Heating,and Refrigeration Institute CERTIFICATE NO.: 131674999695401660