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HomeMy WebLinkAboutBuilding Permit Application • ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: ! /B- ��1r/ Permit Number: ( Ll" c —c 3 7 COCl NTY FLOR I D A 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 end of line PROP.,OSED IMPROVEMENT:,LOCATION: Address: f oLzt //�� Legal Description: -(LJ ( P ck_ ` U/U/ I c4(y toi 1 Property Tax ID#: 34(q -.S46 - 0/45--©®® ' 3 Lot No. `1 Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK :; &Pt°(fr< pti-ce __5(/_.54.2.4vQ. )1) r_ cCosof- g-5haP" ercyvVki._ c5,/v ortr CONSTRUCTION INFORMATION Addition work to be ertormed under this permit—check all apply: HVAC II Gas Tank nGas,Piping Shutters Windows/Doors Q / Electric 0 Plumbing ❑Sprinklers I I Generator 111 Roof Roof pitch Total Sq. Ft of Construction: Sc, Ft.of First Floor: Cost of Construction:$ _5400 Utilities: _Sewer El Septic Building Height: OWNER/LESSEE:" CONTRACTOR:` Name Qni %1�itll>V/4-1— Name ` >f -- Address, L--&-31-14 CiCompany: l t "erY State: Addre i Gd • . zovt Zip Code: .3.4475 Fax: 1� City: F'f`$( Lc'ct State: Fe Phone No. 77J-- " C2 ` 4' Zip Code:,--34-e7 s-3 Fax: 132T" 735- E-Mail: Phone No. 22d." 03 - ,5-C9 1, Fill in fee simple Title Holder on next page(if different E-Mail: i✓fo'(�,f F}�7.2- ', 4'/` r js�( from the Owner listed above) State or County License: 04ea58,5-e3 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. 871 „ 4 9 3 5 / . SUPPLEMENTAL CONSTRUCTION•LIEN;LAW INFORMATIONI 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: • 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 commenci g work or recording your Notice of Commencement. / ,,, c::::: y , , 411111P' /-1.:- s Signat e of Owner/Lessee/Contra. as Agent for Owner Signature of Contractor/License Hcy STATE OF FLORIDA J STATE OF FLORIDA COUNTY OF c_ i_VGtG - COUNTY OF 3'f Lci'Ct& The forwing instrum nt was acknowledged before me The forgoing instrumen as acknowledged before me this / day of in*/ ,. 20/f by this day of 4,/ "/ ,20 45.by • ��mie I-- 4V1QII.lL' def:Wrwe L erijA (Name of person acknowledging) J (Name of person acknowledging) `/ aia Iqs- 1) , ,,. $ • ar,..„.„P 4 , cu.*, (Signature of Notary Public:-State o i lorida) (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 * .•••••„t. CAROL A.YV�AGLE r00%''use, CAROL ft WEAGLE Commission No. * --1 A * MY�SSIONMFF094208 Commission No. * N _� * M �MISSIONitFF094208 ' :Tl` XPIR S:April 5,2018 *;7 XPIRSES:April 5,2018 . fj��EiF�o" Bonded•,mruBudget Notary Services °'4POFF%0� 8aidedinruBudgetNopryServites� Revised 07/15/2014 _ REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS • .o1 CERTIFIED® www.ahridirectory.org Certificate of Product Ratings AHRI Certified Reference Number:201498281 Date:05-16-2018 Model Status:Active Old AHRI Reference Number:10206647 AHRI Type:RCU-A-CB Series:GSX16 Outdoor Unit Brand Name:GOODMAN Outdoor Unit Model Number (Condenser or Single Package):GSX160361 F` Indoor Unit Model Number(Evaporator and/or Air Handler):ASPT39C14A* 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,GOODMAN product is responsible for the rating of this system combination. .....E 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:34200 SEER:'14.50 EER(A2)-Single or High Stage(95F),:12.20 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. Ratings that are accompanied by WAS indicate an involuntary re-rate. The new published rating is shown along with the previous(i.e.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),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.ahridirectory.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; m-- 101111 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 www.ahridirectory.org,click on"Verify Certificate"link make life better"' 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.: 131709438229382312