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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: :Z Permit Number: w Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 452-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATI.00_ Address: E e Legal Description:0!K__ -y'- - 6 �0 ,� � ' J2. Q-7 Property Tax ID #: 60 � r O&C . i Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION 01-1NOI K. )�G� 'T"� v 6"- torr CONSTRUCTION INFORMATION: ACIamonalworkt0beiJerfornipci HVAC 0 Gas Tank LIGas"Piping 11 Electric ❑ Plumbing Sprinklers Total Sq. Ft of Construction: Cost of Construction: $ Name Shutters E]Windows/Doors Generator 11 Roof Q Roof pitch S _ Ft. of First Floor: _ Utilities:Sewer ElSeptic LESSEE: CONTRACTOR:, Address: 4 0 J City: I ,�, State: E4 Zip Code: Phone No. 5 2. - 3 0' 904-5 E -Mail: /V ) A - Fill in fee simple Title Holder on next page (if different from the Owner listed above) Building Height: Name: I . !' Company. ` Address: f, 7b City: State:P Zip Code: Fax ' Z ta,' " Phone N E -Mail. 1 �3�GrC i State or County License: Caw &3 gle Le If value Of construction is $2500 Or more, a RECORDED Notice of Commencement is required. M�N�'ALC�NSTRUCT(QtV SEN LA�tiNF�3RiVfATIQN: 13�ESIGNER/ENGINEER: � Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address- Address: City= State: City= State: Zip: Phare Zip: Phare: FEE SIMPLE TITLE HOLDER: � Not Applicable BONDING COMPANY: Nat Applicable Name: (dame: 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, wails, 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 commencin work or recordingour Notice of Commencement. :7 Signature of Owner/ Le see/Contractor as Agent for Owner Signature of Corrtractor/License Halder STATE OF FLORIDA COUNTY OF L'C���t'1, - STATE OF 1=i,Q�gQ COUNTY OF c��t . 6 � The fs�r�oing instrument was acknowledged before me this ..GG ��lay of _ - , ZD� by The fo„ rgepng instrument was acknowledged before me this ��day af�,} 20,JL by A 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 Produced I i (Signature of Notary {Signature of Notary Publ' 1 © NAM. HILL Commission N +CO�fpN#GG 099038 EXP ES. J� 130, • •• 130NidA M. HILL Commission N = MY SIGN#GG 099036 E�:.4pr17 :�Fgx�n;,• pri 2021 •.......• Bended Ther Notary Public lJndetwiitets • F 30, 2027 �" •�f.� Bonded 1'hru AfuRary Public Undetwdters REVIEWS FRONT ZONING SUPERVISOR FLANS VEGETATION SEA TURTLE .MANGROVE COUNTER REVIEW REVIEW Rl;iflEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 8/2/'17 This combination qualifies for a Federal Energy Efficiency tax Credit when placed in service between Feb 17,2009 and Dec 31, 2016. Certificate of Product Ratinas AHRI Certified Reference Number: 8900214 Date: 05-02-2018 Model Status: Active AHRI Type: RC1 -A -CB Series: LX SERIES Outdoor Unit Brand Name: CHAMPION HEATING AND COOLING Outdoor Unit Model Number (Condenser or Single Package) : TC7B3021 Indoor Unit Model Number (Evaporator and/or Air Handler) : AE30BX21+TXV 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 CHAMPION HEATING AND COOLING product is responsible for the rating of this system combination. Rated as follows in accordance with the latest edition of ANSI/AHRI 2101240 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 : 27800 SEER: 17.00 EER (A2) - Single or High Stage (95F) : 14.00 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 gs that aor offering far sale. Ratinre accompanied by WAS indicate an involuntary re -rate- The new published ratings shown alono with the previous 6-o 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.ahridlrectory.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, AM 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 and enter the AHRI Certified Reference Number and the date on which the certificate was issued, we in4% e life better - which is listed above, and the Certificate No., which is listed at bottom right. 02018Air-Conditioning, Heating, and Refrigeration Institute I CERTIFICATE NO.: 131697596763172295