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HomeMy WebLinkAboutSHARON O'CONNOR PERMIT APP ALL AP LE IN O MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED PLICA Date: 1 Permit Number: Building Permit Application Planning and Development5ervices 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 PROPOSED IMPROVEMENT LOCATION Address:13 6. r -.� Legal Description: b - Property Tax ID M [�`S z 1 _..,.._ Lot No. Site Plan Name: Block No. Project Name: 01 Mth Setbacks Front Back: Right Side: Left Side: Vw1�L�1:_• YILED DESCRIPTION-05 WORK: a ftk, I1 K Gpt b�' f° CONSTRUCTION INFORMATION. AC101tional work to be ne-ffo-rmed under this permit-checK all apply: OHVAC OGasTank ElGas Piping _Shutters Windows/Doors Electric PlumbingSprinklers 11 Generator Roof Roof pitch Total Sq.Ft of Construction: S . Ft.of First Floor. Cost of Construction:$ Eltilities:�Sewer L_—_I Septic Building Height: OWNER/LESSEE; CONTRACT QR: Name Name: Address: JJL5Q Company: City: M1W b 0 State: Address: r Zip Code: Fax. City: State. Phone No. 4� Zip Code: Fax - ( E-Mail: Phone Na. wrs Fill in fee simple Title Holder on next page(if different E-Mail: , from the Owner listed above) State or County License: If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. °SUP€LEMENTALCONSTRUCTtaDN tEN:L;41N IN FORMAT lON. DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Alaplieable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Appl}cable }Name: Name: Address: Address: City: City: Zip: Phone:. Zip: Phone: OWN ER/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 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 -ire accordance with the approved plates,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 worts or recording our Notice of Commencement. 71 Signature of Owner/Lessee/Contractor as Agent for owner Signature of Contractor/License Holder STATE OF FLORIDA - STi AM OF FLOfiffQA COUNTY OF COUNTY OF C. The fof r�yng instr ent was acknowledggf{before me The fo doing instn.trtient was acknowledged before me this '`'1i ay of 20 by this 'may of c ]AAL 26—L by Name of person making statement Name of person making statement Personally Known__.)OR Produced Identification Personally Known_X OR Produced Identification Type of Identification Type of Identification Produced Produced k�M > (Signature of Notary T� NAM.HILL DONNA(Signature of Notary Publi ' .-� M.NII..L I Commission N OOI N9Go0990as Commission N MyWION#GG099039 !. P- ETh ES pil13 0,2021 April 30,2021 Bonded Thru Nat2ljr f�Gs Undenurilera ���. '' Bonded Yfim NoEery Pi+hflc Underwriters REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE DATE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW RECEIVED DATE COMPLETED Rev.812/17 This combination qualifies for a Federal Energy Efficiency tax Credit when At LOW Placed in service between Feb 17,2009 and Dec 31, 2016. WMILI CERTIFIED Certificate of Product Ratings AHRI Certified Reference Number:9115221 Date:06-14-2018 Model Status:Active AHRI Type:SP-A Series: LX SERIES Outdoor Unit Brand Name:CHAMPION HEATING AND COOLING Outdoor Unit Model Number (Condenser or Single Package):PCE61336* 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 210I240 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:36000 SEER:16.00 EER(A2)-Single or High Stage(95F) : 12.50 f"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. Ratio s that are aZ2M nied bX WAS indicate an involunta re-rate. The new ublished rating is shown algna with the previous i_e.WAS ratio . 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; 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 A 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 make life better' which is listed above,and the Certificate No.,which is listed at bottom right. 02018Air-Conditioning, Heating,and Refrigeration Institute CERTIFICATE NO.: 131734778380044611