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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLEINFOMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: i I Permit Number: Building Permit Application Planning and ©evelopment5ervices Building and Code Regulation Division 2304 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 encs of line PROPOSED° MPROVEMENT: LOCATION: Address: 4LO ID Legal Description: FO " Property Tax Ip #: "� V�} Lot No. Site Plan. Name: Block No. Project Name: _ h 's L Setbacks Front Back: Right Side: Left Side: DETAILED "DESCRIPTION Q_ FWOR E. 1iK'-; b bW h)00; `SCC � W C--, -PC (49444-110`3 ,)' I4 Sct'r-' CONSTRUCTION :INFORMATION - Additional work toe e Orme un er this permit --check a apply: ,r- OHVAC Ei Gas Tank []Gas Piping i _ Doors nn � Shutters Windows LSI Electric ❑ Plumbing Sprinklers ® Generator Roof Roof pitch Total So. Ft of Construction: Sq- Ft. of First Floor: Cost of Construction: $ Utilities: OSewer []Septic Building Height: OWNER/LESSEE; CaNTRACTOR. Name Address: h i Name: LATnLAEA T. Company. Address: 10,01 4 City: �� mak- _ State: Zip Code: ( Fax:_. Phone No. City: Zip Code: Phone No. E -Mail: f State or County License: _[� Stater Fax{644- -40 -57 y ► ./�• E -Mail: Fill in fee simple Title Halder on next page [ if different from the Owner listed above) it value ®r cvnsrruernon [s :;�cswi ar more, a Kht.UKVLU Notice od c:omrnencement is required. SLt{ Pt. WWAL CQNS7RUCT'ION LJEN ►vu f i RMATI+C)N: DESIGNER/ENGINEER: Not Applicable Name: MORTGAGE COMPANY: Not Applicable Name: Address: Address: City: State: Zip: Phone City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: Address: BONDING COMPANY: Not Applicable Name: 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. f 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 Horne 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 recordinLy your Notice of Commencement. Rev. 8/2/3.7 " Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA , COUNTY OF - i �:'']C� cnrii t STATE OF FL[3��,�A COUNTY OF The for oing instru ent was acknowledge before me �aY The f r ing instrume s acknowledged efore me this of . 201A by this��lay of 20 by [ 4.d T l T Name of person making statement Name of person making statement Personally Known - S OR Produced Identification Personally Known. X _ OR Produced identification Type of Identification Type of Identification Produced Produced {\ j) � � 4 Ll tom+-�^_ � ►L (Signature of Notary (Signature of Notary Publ' f) NAM. HILL Commission N CO N # GG 099038C EXP lRt:6.� �• ,a;• •• DONNA M. HILL Gomrr�ission N ' = 'NY =ION # GG 099038 202 y�•:� ;: �'8ondad Thar No � �i'rc Und �s�Ea PT71 30. 2021 = �• Sodded Tina Natery pu* Undewflers REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW HATE RECEIVED BATE COMPLETED Rev. 8/2/3.7 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 Ratings AHRI Certified Reference Number: 200945843 Date: 05-09-2098 Model Status: Active Old AHRI Reference Number: 6892357 AHRI Type: SP -A Series: GPC14 Outdoor Unit Brand Name : GOODMAN Outdoor Unit Model Number (Condenser or Single Package) : GPC1436H41D* Region: All (AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, Hl, 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 GOODMAN 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 : 35600 SEER: 14.00 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. Ra in s that are accompanied by WAS indicate an involuntary re -rate. The new Published ratina is shown alono with the previous (i.e. WAS) ratina 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.ahridireetory.org. TERMS AND CONDITIONS This Certificate and its contents are proprietary products o#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, NIP 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, Nve make life better" which is listed above, and the Certificate No., which is listed at bottom right. 02018Air-Conditioning, Heating, and Refrigeration Institute FERTiF[CATE NO.; 1317Q354D83f373284