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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLEBINFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED LO �,l `t, r Date: '-/ Permit Number: 1 `� - U Z COUNTY .F, L. O �R -U R - Cen QED Building Permit Application APR 10 Planning and Development Services p 2018 Building and Code Regulation Division e i ng p 2300 Virginia Avenue,Fort Pierce FL 34982 �!�cjecun,'e"t Phone: (772)462-1553 Fax:.(772)462-1578 Commercial Residential V/ PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION: ,I Address: /07015S. lock4--, Up,i1-- �/f 61 (1isv 1 I At.AA ,M57 Legal Description: Property Tax ID#:1/51/.." a. ..? _„00_, Lot No. Site Plan Name: /f (,`C�(/ j OLBlock No. Project Name: / Setbacks Front Back: Right Side: Left Side: 'DETAILED DESCRIPTION OF WORK: ' 4,14‘,. ielt t ply.e d 4C-- 03proLt O.,/A ylp.,,v Aridovv_./olutay, (4,„,.i.i-ti,‘,/4 mil osieF xxVR> 15S-ag i CONSTRUCTION INFORMATION: Additio work to be erformed under this permit—check all- apply: M HVAC Gas Tank ElGas Piping Shutters ElWindows/Doors ❑Electric El Plumbing Sprinklers El Generator ❑ Roof Roof pitch Total Sq. Ft of Construction: S Ft.of First Floor: Cost of Construction: $ .3OJ Utilities: Sewer ElSeptic Building Height: OWNER/LESSEE: CONTRACTOR: f Name /lite. V ovl /fle -o2kif Name: 40 ds/ - Ji .o/y, 0 Address:/0?5 S OLavi. /Jr /,/i?,/ vCompany:4�4 S A/e %y C. City: VLfceyi &di State: C— Address: 2/9 Sw Co/44141 Acid Zip Code: ,310.57 Faxi, 41 City: AI S,/ tuG;e. State:Py_ Phone No. enEr ,g5-.,;71Y-4'6(7 Zip Code: 3i15-3 - Fax: ,V/4 E-Mail: /v/>9 Phone No. `n) y- e6 Fill in fee simple Title Holder on next page(if different E-Mail: ry0440 "r (®r fk'Z�1et— from the Owner listed above) State or County License: CA 2-/$/'O 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 Applicab — 1Ie 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 FLORIDASTATE OF FLORIDA COUNTY OF Sk •L-i-c_C-� COUNTY OF S�` LAJ .CA.€–' The forgoing instrument was acknowledged before me The for_going instrument was acknowledged before me this I J day of Ae `1 ,20_ by this f( day of A\OY L i ,20 18 by �vJ(t J0,rnes E Lu0o0c-1 Cly Le r r-409(-) Jctrnp� L --t Cs 1.eaI Name of person making statement Name of person making statement Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced i-L---‘ D Produced 'FL_I 0 - - t.) --,1 _.•.�. �• GIVE i 1 (Signature of Notaryublic-State of Florida) (Signature of=N Lary 4 bli `t:44.a`f t qr� t0 •`vt' F 4. _ M0 •1RES:Derem bl• IlAdersmle� Commission No.�€ 14? r, "-R` saS Commissiof.No.':,:1.. .. . . °�j,_„s aI pt�tASS1G, bet 16,2,Rites $ ..!*.e.1-„ ' ” 1!, : �:?vc: leC i S:Dype"'-t ndOn / : kart �' d�rN SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE REVIEWS INDst,'' �'"- C *f VIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE ' COMPLETED Rev.8/2/17 This combination qualifies for a Federal Energy Efficiency tax Credit when ANk LI P ® ' placed in service between Feb 17,2009 and Dec 31, 2016. AI INN 1.1 CERTIFIED www.ahridirectory.org Certificate of Product Ratings AHRI Certified Reference Number:5617718 Date:04-09-2018 Model Status:Production Stopped AHRI Type:SP-A Series:NUTONE P5RF SERIES Outdoor Unit Brand Name:NUTONE Outdoor Unit Model Number (Condenser or Single Package) 121=1/ 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,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 NUTONE product is responsible for the rating of this system combination. • Rated as follows in accordance with thelatestedition 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)-Singleor High Stage-(95F),btuh:23400 SEER:15.00 EER.(A2)-Single or High Stage(95F) :12.00 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. Ratin.s that are accom•anied b WAS indicate an involunta re-rate. The new•ublished ratin•is sh.wn alon.with the•revious i.e.WAS,.ratin.. 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.ahrldlrectory.org. TERMS AND CONDITIONS This Certificate and its contents are proprietary products of AHRI.This Certificate shall only be used for individual,personal and - 'r�I 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 wwnv.ahrldlrectory.org,click on"Verify Certificate"link we make life bette,m 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. ©2018Air-Conditioning,Heating,and Refrigeration Institute CERTIFICATE NO.: 131677750789445277