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Home My WebLink AboutBuilding Permit ApplicationALL APPLICABLE INFO 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 and of line PROPOSED IMPROVE MEN 'LOCATION..- Address: OCATIONrAddress: Legal Description: S b E Iii' N UJ 114,1 6� N IJU d< 1 - Property Tax ID ##: _ 15z- Lot No. Site Plan Name: Block No. Project Name:.. . CONSTRUCTION `'INFORMATION : itiona wor toBe e Orme un4ert Es permit -c —check anShutters appy: ` HVAC 13Gas Tank Gas Piping _ Windows/Doors L !Electric 0 Plumbing �5prinkler5 Generator Roof Roof pitch Total Sq. Ft of Construction: Cost of Construction: $ ,Sq. Ft. of First Floor. _ Utilities:Sewer []Septic Building Height: OWNER/LESSEE. CONTRACTOR: NameLLName:c 7RiY1) [} T t.Y fM ••r- j I j i Phone• , 1 r A r< Fill in fee simple Title Holder on next page (if different from the Owner listed above) State or County License: If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. - .f $u�� ENTAL CONST LIEN. LAW- I NFORMATIu: DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY; Not ApplicableName: Name: Address: Address: City: State: City: Ti State: P: 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 AFFIDVITR 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 COUNTY OF -s The for ing instru nt was acknowledg4before me this Mayof 20by ss Name of person making statement Personally Known ') _ OR Produced identification Type of identification Produced (Signature of Notary Commission REVIEWS IFRONT COUNTER DATE RECEIVED DATE COMPLETED Rev. 8/2/17 uot#GG . HILL 099038��f30, 2021 6&c Undenvrllers ZONING SUPERVISOR REVIEW REVIEW STATEOFFLORMA COUNTY OF _ The forgnot�"n�g instrum t was acknowledged before me this! May of MCI q 2i}& by lJL1 r f Name of person making statement Personally Known. X OR Produced Identification Type of Identification Produced C)� - - q -n n (Signature of Notary Publ' DON M. HILL Commission N, - My51014 # GG 099038 April 3o, 2021 Boaded fi omm Publk Uadenvriters PLANS I VEGETATION I SEA TURTLE I MANGROVE REVIEW REVIEW REVIEW REVIEW ■nalCERTIFIED° www.atiridirattoi,y.org Ah da 0 This combination qualifies for a Federal Energy Efficiency tax Credit when placed in service between Feb 17,2009 and Dec 31, 2016. Product Ratings AHRI Certified Reference Number: 8900647 Date : 05-03-2018 Model Status : Active AHRI Type: RCU-A-CB Series: LX SERIES Outdoor Unit Brand Name: CHAMPION HEATING AND COOLING Outdoor Unit Model Number (Condenser or Single Package) : TC783621 Indoor Unit Model Number (Evaporator and/or Air Handler) : AE36BX21+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 priorto 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 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 : 34600 SEER: 16,25 EER (A2) - Single or High Stage (95F) : 13.50 t"Active" Madel 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. 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 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. of the product(s), or the TERMS AND CONDITIONS This Certificate and its contents are proprietary products of AHRI. This Certificate shall only be used for individual, personal confidential reference purposes. The contents of this Cerlificate A may not, in whole Orin part, be reproduced; copied; dissemand inated; entered into a computer database; or otherwise utilized, in any form or manner or by any means, for -M except the user's individual, personal and confidential reference. CERTIFICATE VERIFICATION AIR-CONDITIONING, HEATING, 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 the date & REFRIGERATION INSTITUTE and on which the certificate was issued, which is listed above, and the Certificate No., which is listed at bottom right. we make life better` e02018Air-Conditioning, Heating, and Refrigeration Institute CERTIFICaTI= Nn. 134698334654955335